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Clinical results and short-term survivorship of robotic-arm-assisted medial and lateral unicompartmental knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this multicentre, retrospective, observational study was to determine the incidence of revision and clinical results of a large cohort of robotic-arm-assisted medial and lateral UKAs at short-term follow-up. It was hypothesized that patients who receive robotic-arm-assisted UKA will have high survivorship rates and satisfactory clinical results.

Methods

Between 2013 and 2016, 437 patients (470 knees) underwent robotic-arm-assisted medial and lateral UKAs at two centres. Knee Injury and Osteoarthritis Outcome Score (KOOS), Forgotten Joint Score 12 (FJS-12) and Short-Form Physical and Mental Health Summary Scales (SF-12) were administered to estimate patients’ overall health status pre- and post-operatively. Results were dichotomized as ‘excellent’ and ‘poor’ if KOOS/FJS-12 were more than or equal to 90 and SF-12 was more or equal to 45. Associations between patients’ demographic characteristics and clinical outcomes were investigated. Post-operative complications and pain persistence were recorded.

Results

Following exclusions and losses to follow-up, 338 medial and 67 lateral robotic-arm-assisted UKAs were assessed at a mean follow-up of 33.5 and 36.3 months, respectively. Three medial UKAs were revised, resulting in a survivorship of 99.0%. No lateral implants underwent revision (survivorship 100%). On average, significant improvement in all clinical scores was reported in both medial and lateral UKA patients. In medial UKA patients, male gender was associated with higher probability of better scores in overall KOOS, FJS-12 and in specific KOOS subscales. No other associations were reported between biometric parameters and outcome for either medial or lateral UKA.

Conclusions

Robotic-assisted medial and lateral UKAs demonstrated satisfactory clinical outcomes and excellent survivorship at 3-year follow-up. Continued patient follow-up is needed to determine the long-term device performance and clinical satisfaction.

Level of evidence

Retrospective cohort study, Level IV.

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Abbreviations

UKA:

Unicompartmental knee arthroplasty

TKA:

Total knee arthroplasty

IRB:

Institutional review board

ACL:

Anterior cruciate ligament

BMI:

Body mass index

KOOS:

Knee Injury and Osteoarthritis Outcome Score

FJS-12:

Forgotten Joint Score 12

SF-12:

Short-Form Physical and Mental Health Summary Scales

MCID:

Minimal clinically important difference

OR:

Odds ratios

CI:

Confidence interval

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Funding

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio-Emilia, Via del Pozzo, 71, 41124, Modena, Italy

    Francesco Zambianchi, Elisa Rivi, Andrea Marcovigi & Fabio Catani

  2. Department of Knee Surgery, Policlinico Abano Terme, Abano Terme, PD, Italy

    Giorgio Franceschi & Claudio Khabbazè

  3. Statistics Unit, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio-Emilia, Modena, Italy

    Federico Banchelli

Authors
  1. Francesco Zambianchi
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  2. Giorgio Franceschi
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  3. Elisa Rivi
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  4. Federico Banchelli
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  5. Andrea Marcovigi
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  6. Claudio Khabbazè
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  7. Fabio Catani
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Contributions

FZ made substantial contributions to study conception and design and wrote the paper. GF and ER acquired the data. FB performed the statistical analysis. AM and CK interpreted the results and revised the manuscript critically. FC conceived of the study, participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Francesco Zambianchi.

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Conflict of interest

FC discloses conflict of interests relating to the present papers; in particular, fees and honoraria have been received for consultancy and education purposes. All other authors declare they have no competing interests relative to the present paper.

Ethical approval

The present study was performed in accordance with the Ethical Standards of the 1964 Helsinki Declaration and its later amendments, and IRB approval was obtained (69/2018/OSS/AOUMO, transmitted with protocol N. 0008124/18)

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Zambianchi, F., Franceschi, G., Rivi, E. et al. Clinical results and short-term survivorship of robotic-arm-assisted medial and lateral unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 28, 1551–1559 (2020). https://doi.org/10.1007/s00167-019-05566-4

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  • DOI: https://doi.org/10.1007/s00167-019-05566-4

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