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Robot-assisted vs. conventional unicompartmental knee arthroplasty

Systematic review and meta-analysis

Roboterassistierte vs. konventionelle unikompartimentäre Knieendoprothese

Systematisches Review und Metaanalyse

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Abstract

Numerous advances have been made in prosthesis design, instrumentation and postoperative rehabilitation for unicompartmental knee arthroplasty; however, only 70–86% of patients are satisfied with the functional outcome and revision rates range between 10% and 20%. The primary outcome for this meta-analysis was implantation accuracy of component positioning and tibiofemoral component safe zone. A total of three randomized controlled trials (RCT), three quasi-RCTs and one prospective trial were included in this review. It was found that the use of robotic-assisted systems reduces implantation errors without an increase in adverse events. There are only a few reports about clinical outcome and long-term follow-up and whether the more accurate component positioning results in a better clinical effect or a better long-term survival of the implants is unknown.

Zusammenfassung

Trotz vieler Fortschritte bezüglich des Prothesendesigns, Instrumentariums und der postoperativen Rehabilitation bei unikompartimentären Knieendoprothesen sind nur 70–86 % der Patienten mit dem funktionellen Outcome zufrieden; die Revisionsraten liegen zwischen 10 % und 20 %. Das primäre Outcome dieser Metaanalyse war die Genauigkeit der Positionierung von Komponenten bei Implantation sowie die Sicherheitszone bei tibiofemoralen Komponenten. Insgesamt 3 randomisierte kontrollierte Studien (RCT), drei Quasi-RCT und eine prospektive Studie wurden in diesen Review eingeschlossen. Es wurde festgestellt, dass die Verwendung roboterassistierter Systeme die Implantationsfehler reduziert, ohne dass die Zahl der unerwünschten Ereignisse steigt. Hinsichtlich des klinischen Outcomes und Langzeit-Follow-up liegen nur wenige Berichte vor. Ob eine genauere Positionierung der Komponenten bessere klinische Effekt oder eine längere Langzeithaltbarkeit der Implantate erzielt, ist unbekannt.

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Abbreviations

AKS:

American Knee Society

CT:

Computed tomography

MeSH:

Medical Subject Headings

PCT:

Prospective cohort trial

QUORUM:

Quality of reporting meta-analyses

RCT:

Randomized controlled trial

ROM:

Range of motion

TKA:

Total knee arthroplasty

UKA:

Unicompartmental knee arthroplasty

WOMAC:

Western Ontario and McMaster Universities Osteoarthritis

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Funding

This work was supported by the Translational Medicine Project of Chinese People’s Liberation Army General Hospital (2016TM-004).

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Authors and Affiliations

  1. Department of Orthopaedics, Chinese People’s Liberation Army General Hospital (301 Hospital), 28 Fuxing Rd, 100853, Beijing, China

    Jun Fu, Xiang Li, Baozhan Yu, Ming Ni, Wei Chai, Libo Hao & Jiying Chen

  2. Clinical Department of Surgery, Chinese People’s Liberation Army General Hospital (301 Hospital), 28 Fuxing Rd, 100853, Beijing, China

    Yuning Wang

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  1. Jun Fu
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  3. Xiang Li
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Corresponding author

Correspondence to Jiying Chen.

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Conflict of interest

J. Fu, Y. Wang, X. Li, B. Yu, M. Ni, W. Chai, L. Hao and J. Chen declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Yuning Wang and Xiang Li share the first authorship.

The manuscript submitted does not contain information about medical device(s)/drug(s).

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Fu, J., Wang, Y., Li, X. et al. Robot-assisted vs. conventional unicompartmental knee arthroplasty. Orthopäde 47, 1009–1017 (2018). https://doi.org/10.1007/s00132-018-3604-x

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  • DOI: https://doi.org/10.1007/s00132-018-3604-x

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