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Operating room efficiency after the implementation of MAKO robotic-assisted total knee arthroplasty

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The aim of this study was to examine if robotic-assisted total knee arthroplasty (RATKA) is cost- and time-effective in terms of implant stock and perioperative parameters, as optimizing perioperative efficiency may contribute to value-based care.

Materials and methods

Four hundred thirty-two consecutive patients who received primary total knee arthroplasties (TKAs) from May 2017 to March 2020 in a regional hospital were included in this study. Operating room time (OR time), surgical time, number of trays, insert thickness, and length of stay (LOS) were assessed and compared for a cohort group with navigation-assisted procedures to a group with robotic-assisted procedures (MAKO, Stryker, USA). Prediction of implant size was assessed for the robotic-assisted group. The Mann–Whitney U test was used for comparisons between groups when the normality assumption was not met. Categorical variables were assessed using the Fisher’s exact test. p < 0.05 was considered statistically significant.

Results

In the RATKA group, we noticed a significant mean reduction of 11 min in total OR time (p < 0.001), the use of thinner insert (p < 0.001), and a shorter mean length of stay of 1 day (p < 0.001). Compared to the navigation group, surgical time was not significantly longer, nor clinically relevant (0.238). In 76.9% of the robotic-assisted cases, the estimated implant size was equal to the final size and in all other cases, the preoperative implant size was oversized.

Conclusion

The introduction of the MAKO robotic-assisted total knee arthroplasty resulted in a gain in operating room time, a thinner and more predictable insert thickness, a shorter length of stay in hospital, and less instrumentation compared to navigation-assisted procedures.

Level of evidence

Level III, Retrospective cohort study.

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Data availability

All data are anonymous available in a computer database.

Abbreviations

ASA:

American Society of Anesthesiologists

BMI:

Body mass index

CPM:

Continuous passive motion

IRB:

Institutional review board

LMWH:

Low-molecular-weight heparins

LOS:

Length of stay

OR:

Operation room

RATKA:

Robotic-assisted total knee arthroplasty

SD:

Standard deviation

THA:

Total hip arthroplasty

TKA:

Total Knee Arthroplasty

UKA:

Unicompartmental knee arthroplasty

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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. Orthopaedic Surgery, KU Leuven, Herestraat 49, 3000, Leuven, Belgium

    Laura Loomans

  2. Orthopaedic Surgeon, Noorderhart, 3900, Pelt, Belgium

    Geert Leirs

  3. Orthopaedic Surgeon, Department of Orthopaedics, University Hospital Leuven, Department of Development and Regeneration, Institute for Orthopaedic Research and Training (IORT), KU Leuven, 3000, Leuven, Belgium

    Hilde Vandenneucker

Authors
  1. Laura Loomans
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  3. Hilde Vandenneucker
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Correspondence to Laura Loomans.

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Conflicts of interest

GL has a financial conflict of interest with Stryker, he received speaker and consultancy fee.

Institutional review board ethical approval was awarded prior to study initiation. This article was primary edited by L. Loomans.

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Loomans, L., Leirs, G. & Vandenneucker, H. Operating room efficiency after the implementation of MAKO robotic-assisted total knee arthroplasty. Arch Orthop Trauma Surg 143, 5501–5506 (2023). https://doi.org/10.1007/s00402-023-04834-w

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  • DOI: https://doi.org/10.1007/s00402-023-04834-w

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