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MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to investigate the clinical and radiological results of the MAKO CT-based robotic-assisted system for total knee arthroplasty (TKA).

Methods

A PRISMA systematic review was conducted using four databases (MEDLINE, EMBASE, Pubmed, GOOGLE SCHOLAR) to identify all clinical and radiological studies reporting information regarding the use and results of the CT-based robotic-assisted system to perform TKA between 2016 and 2020. The main investigated outcome criteria were postoperative pain, analgesia requirements, clinical scores, knee range of motion, implant positioning and the revision rate. The ROBINS-I tool (Risk Of Bias In Non-randomized Studies of Interventions) was used to evaluate the quality of included studies and the risk of bias.

Results

A total of 36 studies were identified, of which 26 met inclusion criteria. Of these 26 studies, 14 were comparative. The follow-up varied from 30 days to 17 months. This CT-based, saw cutting Robotic TKA is associated with a significantly lower postoperative pain score (2.6 versus 4.5) and with significantly reduced time to hospital discharge (77 h versus 105), compared with conventional TKA. The two comparative studies assessing functional outcomes at 1 year reported significantly better functional scores with CT-based robotic TKA compared with conventional TKA (WOMAC score: 6 ± 6 versus 9 ± 8 (p < 0.05); KSS function score: 80 versus 73 (p = 0.005)). Only three comparative studies assessed implant positioning, and these reported better implant positioning with CT-based robotic-assisted TKA.

Conclusion

The CT-based robotic-assisted system for TKA reduced postoperative pain and improved implant positioning with equal or slightly superior improvement of the functional outcomes at one year, compared to conventional TKA.

Level of evidence

Systematic review level IV.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Orthopaedic Department, Lyon North University Hospital, Hôpital de La Croix Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix Rousse, 69004, Lyon, France

    Cécile Batailler, Andrea Fernandez, John Swan, Elvire Servien & Sébastien Lustig

  2. IFSTTAR, LBMC UMR_T9406, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France

    Cécile Batailler & Sébastien Lustig

  3. EA 7424, Interuniversity Laboratory of Human Movement Science, Université Lyon 1, Lyon, France

    Elvire Servien

  4. Department of Trauma and Orthopaedic Surgery, University College London Hospital, London, UK

    Fares S. Haddad

  5. Department of Trauma and Orthopaedic Surgery, The Princess Grace Hospital, London, UK

    Fares S. Haddad

  6. Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio-Emilia, Modena, Italy

    Fabio Catani

Authors
  1. Cécile Batailler
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  2. Andrea Fernandez
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  3. John Swan
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  4. Elvire Servien
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  5. Fares S. Haddad
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  6. Fabio Catani
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  7. Sébastien Lustig
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Contributions

CB: study design, data collection, literature review and manuscript writing. AF: literature review and manuscript writing. JS, ES: study design, literature review and manuscript editing. FH, FC: study design and manuscript editing. SL: study design, supervision, literature review and manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cécile Batailler.

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Conflict of interest

CB, AF and JS declare that they have no conflict of interest. ES: consultant for Corin. FH: Royalties from Stryker, Smith & Nephew, MatOrtho, Corin, Springer; Paid presentations from Stryker, Smith & Nephew, MatOrtho, Zimmer; Consultant from Stryker, Smith & Nephew; Research support from Stryker, Smith & Nephew, MatOrtho, Corin, Zimmer; Orthopaedic publications editorial for Bone and Joint Surgery, Annals of Royal College of Surgeons, Hospital Medicine. FC: Consultancy fees, royalties, and fees for participation in review activities from Stryker and consultancy fees from Adler. SL: consultant for Stryker, institutional research support to Corin and Amplitude.

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Batailler, C., Fernandez, A., Swan, J. et al. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 29, 3585–3598 (2021). https://doi.org/10.1007/s00167-020-06283-z

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