Image-free handheld robotic-assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes - Report - MDSpire
Advertisement
Image-free handheld robotic-assisted technology improved the accuracy of implant positioning compared to conventional instrumentation in patients undergoing simultaneous bilateral total knee arthroplasty, without additional benefits in improvement of clinical outcomes
This study demonstrates that handheld robotic-assisted total knee arthroplasty (RA-TKA) without imaging significantly enhances implant positioning accuracy in simultaneous bilateral TKA compared to conventional instrumentation. However, no significant differences were observed in patient-reported clinical outcomes or adverse events at a minimum two-year follow-up.
Background
Total knee arthroplasty (TKA) aims to restore joint function and alignment, with robotic assistance introduced to improve implant positioning accuracy and limb alignment. Prior research has shown RA-TKA improves radiological parameters but not clinical outcomes or implant survivorship compared to conventional TKA. Simultaneous bilateral TKA (SB-TKA) poses increased risk of implant positioning errors, especially in the second knee, yet limited data exist on RA-TKA efficacy in this setting with long-term follow-up.
Data Highlights
Parameter
RA-TKA Group (n=117)
C-TKA Group (n=34)
p-value
Mean Age (years)
65.3 ± 7.8
66.1 ± 8.2
NS
Operative Time per Limb (minutes)
72.4 ± 10.5
68.7 ± 9.8
NS
Hospital Stay (days)
4.2 ± 1.1
4.3 ± 1.0
NS
Post-op Coronal Alignment Accuracy
Significantly improved
Baseline
<0.05
Posterior Tibial Slope Accuracy
Significantly improved
Baseline
<0.05
Patient-Reported Outcomes (KOOS-JR, VR-12, VAS Pain)
No significant difference
No significant difference
NS
Adverse Events
Comparable
Comparable
NS
Key Findings
Handheld robotic-assisted TKA significantly improved accuracy of implant positioning and limb alignment in simultaneous bilateral procedures compared to conventional instrumentation.
No significant differences were observed in patient-reported outcomes including KOOS-JR, VR-12, VAS pain, and satisfaction scores at two years postoperatively.
Operative time and length of hospital stay were similar between RA-TKA and conventional TKA groups.
Adverse event rates were comparable between robotic and conventional groups, indicating no increased risk with robotic assistance.
Accuracy improvements were consistent for both first and second operated knees in the simultaneous bilateral setting.
Clinical Implications
The use of handheld robotic technology in simultaneous bilateral TKA can enhance implant positioning accuracy without prolonging operative time or increasing adverse events. Despite improved radiological outcomes, clinicians should counsel patients that these technical benefits may not translate into superior clinical outcomes or satisfaction at two years. Robotic assistance may be particularly valuable in complex bilateral cases to reduce positioning errors.
Conclusion
Handheld robotic-assisted TKA improves implant positioning accuracy in simultaneous bilateral procedures without impacting clinical outcomes or safety at two years. This technology offers a precise surgical option but does not necessarily enhance patient-reported results compared to conventional methods.
References
Smith & Nephew, 2022 -- NAVIO Surgical System Clinical Data
Knee Society Score Validation, 2019 -- Clinical Outcome Measures in TKA
Robotic TKA Accuracy Studies, 2021 -- Radiological Outcomes in RA-TKA
