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Robotic assisted Total Knee Arthroplasty (TKA) is not associated with increased patient satisfaction: a systematic review and meta-analysis

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Abstract

Purpose

Total knee arthroplasty (TKA) is a common orthopedic surgery, yet postoperative dissatisfaction persists in around 20% of cases. Robotic total knee arthroplasty (rTKA) promises enhanced precision, but its impact on patient satisfaction compared to conventional TKA remains controversial (cTKA). This systematic review aims to evaluate patient satisfaction post-rTKA and compare outcomes with cTKA.

Methods

Papers from the following databases were identified and reviewed: PubMed, Scopus, Web of Science, and the Cochrane Online Library, using keywords like "Knee replacement," "Total knee arthroplasty," "Robotic," and "Patient satisfaction." Extracted data included patient satisfaction measures, Knee Society Score, Oxford Knee Score, Forgotten Joint Score, SF-36, HSS, and KOOS. Statistical analysis, including odds ratio and 95% CI was performed using R software. Heterogeneity was assessed using Cochrane's Q test.

Results

The systematic review included 17 articles, involving 1148 patients (571 in the rTKA group and 577 in the cTKA group) assessing patient satisfaction following rTKA. An analysis of proportions reveals rTKA satisfaction rate was 95%, while for cTKA, it was 91%. A meta-analysis comparing rTKA and cTKA found no statistically significant difference in patient satisfaction. Additionally, various patient-reported outcome measures (PROMs) were examined, showing mixed results across different studies and follow-up periods.

Conclusions

The results of this study found no difference in patient satisfaction outcomes in the short to mid-term for rTKA compared to conventional methods. This study does not assert superiority for the robotic approach, highlighting the need for careful consideration of various factors influencing outcomes in knee arthroplasty.

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Data availability

A sheet of extracted data from the included articles is available upon request; please contact the corresponding author for access.

Code availability

All statistical analyses were performed using R software, version 4.2.2, provided by the R Foundation for Statistical Computing in Vienna, Austria (http://www.R-project.org).

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Authors and Affiliations

  1. International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD, USA

    Amir Human Hoveidaei

  2. Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran

    Sina Esmaeili

  3. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Amirhossein Ghaseminejad-Raeini, Kasra Pirahesh & Mohammad Sadegh Fallahi

  4. Joint Reconstruction Unit, Southland Teaching Hospital, Invercargill, New Zealand

    Nemandra A. Sandiford

  5. Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg Holstenstrasse 2, 22767, Hamburg, Germany

    Mustafa Citak

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  1. Amir Human Hoveidaei
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  2. Sina Esmaeili
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  3. Amirhossein Ghaseminejad-Raeini
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  4. Kasra Pirahesh
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  7. Mustafa Citak
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Contributions

A.H.H..: Study design, search string development, data analysis, writing manuscript; S.E.: Paper screening, data extraction; A.G.R.: Paper screening, Data extraction; K.P.: writing manuscript; M.S.F.: writing manuscript; N.A.S.: manuscript review; M.C.: Study design, final supervision, manuscript review; All authors read and approved the final manuscript.

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Correspondence to Mustafa Citak.

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Hoveidaei, A.H., Esmaeili, S., Ghaseminejad-Raeini, A. et al. Robotic assisted Total Knee Arthroplasty (TKA) is not associated with increased patient satisfaction: a systematic review and meta-analysis. International Orthopaedics (SICOT) (2024). https://doi.org/10.1007/s00264-024-06206-4

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