A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty
Aims: Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) have both been shown to be effective treatments for osteoarthritis (OA) of the knee. Many studies have compared the outcomes of the two treatments, but less so with the use of robotics, or individualized TKA alignment...
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The British Editorial Society of Bone & Joint Surgery
2024-12-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0086.R2 |
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| author | Jonathan R. Manara Macdaniel Nixon Beth Tippett Wil Pretty Dermot Collopy Gavin W. Clark |
| author_facet | Jonathan R. Manara Macdaniel Nixon Beth Tippett Wil Pretty Dermot Collopy Gavin W. Clark |
| author_sort | Jonathan R. Manara |
| collection | DOAJ |
| description | Aims: Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) have both been shown to be effective treatments for osteoarthritis (OA) of the knee. Many studies have compared the outcomes of the two treatments, but less so with the use of robotics, or individualized TKA alignment techniques. Functional alignment (FA) is a novel technique for performing a TKA and shares many principles with UKA. Our aim was to compare outcomes from a case-matched series of robotic-assisted UKAs and robotic-assisted TKAs performed using FA. Methods: From a prospectively collected database between April 2015 and December 2019, patients who underwent a robotic-assisted medial UKA (RA-UKA) were case-matched with patients who had undergone a FA robotic-assisted TKA (RA-TKA) during the same time period. Patients were matched for preoperative BMI, sex, age, and Forgotten Joint Score (FJS). A total of 101 matched pairs were eligible for final review. Postoperatively the groups were then compared for differences in patient-reported outcome measures (PROMs), range of motion (ROM), ability to ascend and descend stairs, and ability to kneel. Results: Both groups had significant improvements in mean FJS (65.1 points in the TKA group and 65.3 points in the UKA group) and mean Oxford Knee Score (OKS) (20 points in the TKA group and 18.2 in the UKA group) two years following surgery. The UKA group had superior outcomes at three months in the OKS and at one year in ROM (5°), ability to kneel (0.5 points on OKS question), and ascend (1.3 points on OKS question) and descend stairs (0.8 points on OKS question), but these were not greater than the minimal clinically important difference. There were no differences seen in FJS or OKS at one year postoperatively. There were no statistically significant differences between the groups at 24 months in all the variables assessed. Conclusion: FA-RATKA and RA-UKA are both successful treatments for medial compartmental knee arthritis in this study. The UKA group showed a quicker recovery, but this study demonstrated equivalent two-year outcomes in all outcomes measured including stair ascent and descent, and kneeling. Cite this article: Bone Jt Open 2024;5(12):1123–1129. |
| format | Article |
| id | doaj-art-9da88c491be94666a940e64b73c201f4 |
| institution | Kabale University |
| issn | 2633-1462 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
| record_format | Article |
| series | Bone & Joint Open |
| spelling | doaj-art-9da88c491be94666a940e64b73c201f42025-01-28T05:38:30ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622024-12-015121123112910.1302/2633-1462.512.BJO-2024-0086.R2A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplastyJonathan R. Manara0https://orcid.org/0000-0002-6863-2042Macdaniel Nixon1Beth Tippett2Wil Pretty3Dermot Collopy4Gavin W. Clark5https://orcid.org/0000-0003-3967-1613St John of God Healthcare, Perth, AustraliaSt John of God Healthcare, Perth, AustraliaPerth Hip & Knee, Perth, AustraliaPerth Hip & Knee, Perth, AustraliaSt John of God Healthcare, Perth, AustraliaSt John of God Healthcare, Perth, AustraliaAims: Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) have both been shown to be effective treatments for osteoarthritis (OA) of the knee. Many studies have compared the outcomes of the two treatments, but less so with the use of robotics, or individualized TKA alignment techniques. Functional alignment (FA) is a novel technique for performing a TKA and shares many principles with UKA. Our aim was to compare outcomes from a case-matched series of robotic-assisted UKAs and robotic-assisted TKAs performed using FA. Methods: From a prospectively collected database between April 2015 and December 2019, patients who underwent a robotic-assisted medial UKA (RA-UKA) were case-matched with patients who had undergone a FA robotic-assisted TKA (RA-TKA) during the same time period. Patients were matched for preoperative BMI, sex, age, and Forgotten Joint Score (FJS). A total of 101 matched pairs were eligible for final review. Postoperatively the groups were then compared for differences in patient-reported outcome measures (PROMs), range of motion (ROM), ability to ascend and descend stairs, and ability to kneel. Results: Both groups had significant improvements in mean FJS (65.1 points in the TKA group and 65.3 points in the UKA group) and mean Oxford Knee Score (OKS) (20 points in the TKA group and 18.2 in the UKA group) two years following surgery. The UKA group had superior outcomes at three months in the OKS and at one year in ROM (5°), ability to kneel (0.5 points on OKS question), and ascend (1.3 points on OKS question) and descend stairs (0.8 points on OKS question), but these were not greater than the minimal clinically important difference. There were no differences seen in FJS or OKS at one year postoperatively. There were no statistically significant differences between the groups at 24 months in all the variables assessed. Conclusion: FA-RATKA and RA-UKA are both successful treatments for medial compartmental knee arthritis in this study. The UKA group showed a quicker recovery, but this study demonstrated equivalent two-year outcomes in all outcomes measured including stair ascent and descent, and kneeling. Cite this article: Bone Jt Open 2024;5(12):1123–1129.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0086.R2roboticsarthroplastyfunctional alignmentpartial knee arthroplastyunicompartmental knee arthroplastytotal knee arthroplastyfunctional outcomestotal knee arthroplasty (tka)unicompartmental knee arthroplasty (uka)forgotten joint score (fjs)knee arthroplastyoxford knee scorepatient-reported outcome measures (proms)bmirobotic-assisted unicompartmental knee arthroplastyrobotic-assisted total knee arthroplasty |
| spellingShingle | Jonathan R. Manara Macdaniel Nixon Beth Tippett Wil Pretty Dermot Collopy Gavin W. Clark A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty Bone & Joint Open robotics arthroplasty functional alignment partial knee arthroplasty unicompartmental knee arthroplasty total knee arthroplasty functional outcomes total knee arthroplasty (tka) unicompartmental knee arthroplasty (uka) forgotten joint score (fjs) knee arthroplasty oxford knee score patient-reported outcome measures (proms) bmi robotic-assisted unicompartmental knee arthroplasty robotic-assisted total knee arthroplasty |
| title | A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty |
| title_full | A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty |
| title_fullStr | A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty |
| title_full_unstemmed | A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty |
| title_short | A case-matched series comparing functional outcomes for robotic-assisted unicompartmental knee arthroplasty versus functionally aligned robotic-assisted total knee arthroplasty |
| title_sort | case matched series comparing functional outcomes for robotic assisted unicompartmental knee arthroplasty versus functionally aligned robotic assisted total knee arthroplasty |
| topic | robotics arthroplasty functional alignment partial knee arthroplasty unicompartmental knee arthroplasty total knee arthroplasty functional outcomes total knee arthroplasty (tka) unicompartmental knee arthroplasty (uka) forgotten joint score (fjs) knee arthroplasty oxford knee score patient-reported outcome measures (proms) bmi robotic-assisted unicompartmental knee arthroplasty robotic-assisted total knee arthroplasty |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.512.BJO-2024-0086.R2 |
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