Early Superior Clinical Outcomes in Robotic-Assisted TKA Compared to Conventional TKA in the Same Patient: A Comparative Analysis.

Abstract

Robotic-assisted total knee arthroplasty (RA-TKA) has demonstrated improved alignment and outcome scores when compared with manual total knee arthroplasty (M-TKA); however, few studies compare differences in the same patient. This study is a retrospective review that assesses clinical outcomes of 36 patients who underwent a primary RA-TKA and had undergone a prior contralateral M-TKA. All surgeries were performed by a single surgeon at the same institution. Patients were assessed for differences in hospital length of stay, improvement in pre- versus postoperative range of motion, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. Student's t-test and Fisher's exact test were utilized to detect significant differences. Patient demographics showed a mean age of 64.5, 24 females (67%), and mean body mass index of 35.1 ± 5.7. The average follow-up time was 2.9 years for M-TKA and 1.3 years for RA-TKA. Hospital length of stay was decreased by 5.5 hours for RA-TKA (p = 0.03). Total postoperative WOMAC score was not statistically different between RA-TKA and M-TKA (p = 0.061); however, pain and stiffness components were statistically improved in RA-TKA (p = 0.041 and p = 0.007), respectively. KOOS was higher in RA-TKA, which approached statistical significance (p = 0.005). Pre- versus postoperative knee flexion improved significantly in both cohorts. There was a significant difference in pre- versus postoperative range of motion at 3, 6, and 12 months follow-up after RA-TKA in comparison to M-TKA (p < 0.05). There were no postoperative complications. Patients who underwent RA-TKA demonstrated early improvement at 1-year follow-up in pain, stiffness, and knee flexion when compared with their prior contralateral M-TKA. There was a significant decrease in postoperative length of stay by 5.5 hours in the RA-TKA group. Limitations include a small sample size and differences in follow-up times between RA-TKA and M-TKA.