Comparative Analysis of the Immediate Post-operative Outcomes between Conventional and Fully Automatic Robotic-assisted Total Knee Arthroplasty
Journal of Clinical Orthopaedics | Vol 8 | Issue 2 | Jul-Dec 2023 | page: 12-15 | Sanjay Bhalchandra Londhe, Ravi Vinod Shah, Clevio Desouza, Vijay Shetty, Nicholas Antao, Meghana Patwardhan, Suhail Kantawala
DOI: https://doi.org/10.13107/jcorth.2023.v08i02.582
Author: Sanjay Bhalchandra Londhe [1, 2], Ravi Vinod Shah [1], Clevio Desouza [2, 3, 4], Vijay Shetty [1, 3], Nicholas Antao [2], Meghana Patwardhan [5], Suhail Kantawala [2]
[1] Department of Orthopaedics, Criticare Asia Hospital, Andheri, Maharashtra, India,
[2] Department of Orthopaedics, Holy Spirit Hospital, Andheri, Maharashtra, India,
[3] Department of Orthopaedics, SAANVI Orthopaedics, Mumbai, Maharashtra, India,
[4] Department of Orthopaedics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai,
Maharashtra, India,
[5] Department of Anaesthesia, Criticare Asia Hospital, Andheri, Maharashtra, India.
Address of Correspondence
Dr. Sanjay Bhalchandra Londhe,
Department of Orthopaedics, Criticare Asia Hospital, Andheri, Maharashtra, India.
E-mail: sanlondhe@yahoo.com
Abstract
Background: Different techniques employed during conventional and robotic assisted Total Knee Arthroplasty may lead to variation in the immediate post-operative outcomes. Primary objective of the study was to evaluate the differences in the post-operative pain, analgesics use and length of stay between the RA-TKA and C-TKA. Secondary objective was to study the patient reported outcome measures at six months post TKA.
Materials & Methods: It is a retrospective review of two cohort of patients (C -TKA and RA-TKA) who were operated between January to April 2022. Patients were given the option between C-TKA and RA- TKA. Sample size was estimated to be 28 patients in each group with α error of 0.05 and power of study being 80%. An independent observer analyzed the post-operative parameters like analgesic use, length of stay, VAS score and Oxford Knee Score at 6 months post TKA.
Results: 30 patients in two cohorts were studied. There was no statistically significant difference between the two cohorts as regards the pre-operative patient characteristics. RA- TKA group had a shorter hospital stay (days) than the C-TKA group (3.24±0.50 and 4.07± 0.52, P <0.0001). Pain score (VAS score) was lower in RA -TKA than C-TKA cohort (POD1 5.23 ± 0.50 and 5.93 ± 0.52 POD2 4.40 ± 0.56 and 5.03 ± 0.49, p value <0.0001). R- TKA patients required significantly lower morphine milligram equivalent and NSAIDS than the C-TKA patients (p =0.0005 and p <0.001 respectively). The OKS at 6 months was lower in C-TKA than RA-TKA (32.5± 2.3 C-TKA vs. 33.8±1.5 RA-TKA, p value 0.0120).
Conclusions: RA,-TKA cohort showed significant early advantages like decreased post-operative analgesia usage, shorter length of stay and lower pain scores on day 1 and 2 than the C TKA group. The OKS at 6 months was slightly better in RA-TKA vs. C-TKA.
Keywords: Robotic-assisted total knee arthroplasty, Conventional total knee arthroplasty, Visual analog scale score, Analgesic.
References
1. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: Who is satisfied and who is not? Clin Orthop Relat Res 2010;468:57-63.
2. Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. Patient satisfaction after total knee replacement: Asystematic review. HSS J 2018;14:192-201.
3. Mannan A, Vun J, Lodge C, Eyre-Brook A, Jones S. Increased precision of coronal plane outcomes in robotic-assisted total knee arthroplasty: A systematic review and meta-analysis. Surgeon 2018;16:237-44.
4. Jones CA, Voaklander DC, Suarez-Almazor ME. Determinants of function after total knee arthroplasty. Phys Ther
2003;83:696-706.
5. Lim HA, Song EK, Seon JK, Park KS, Shin YJ, Yang HY. Causes of aseptic persistent pain after total knee arthroplasty. Clin Orthop Surg 2016;9:50-6.
6. Jones CW, Jerabek SA. Current role of computer navigation in total knee arthroplasty. J Arthroplast 2018;33:1989-93.
7. Petursson G, Fenstad AM, Gøthesen O, Dyrhovden GS, Hallan G, Röhrl SM, et al. Computer-assisted compared with conventional total knee replacement. J Bone Joint Surg Am 2018;100:1265-74.
8. Kayani B, Konan S, Tahmassebi J, Pietrzak JR, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: A prospective cohort study. Bone Joint J 2018;100-B:930-7.
9. Marchand RC, Sodhi N, Khlopas A, Sultan AA, Harwin SF, Malkani AL, et al. Patient satisfaction outcomes after robotic arm-assisted total knee arthroplasty: Ashort-term evaluation. J Knee Surg 2017;30:849-53.
10. Naziri Q, Burekhovich SA, Mixa PJ, Pivec R, Newman JM, Shah NV, et al. The trends in robotic-assisted knee
arthroplasty: A statewide database study. J Orthop 2019;16:298-301.
11. Khlopas A, Chughtai M, Hampp EL, Scholl LY, Prieto M, Chang TC, et al. Robotic-arm assisted total knee arthroplasty demonstrated soft tissue protection. Surg Technol Int 2017;30:441-6.
12. Hampp EL, Chughtai M, Scholl LY, Sodhi N, Bhowmik-Stoker M, Jacofsky DJ, et al. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. J Knee Surg 2018;32:239-50.
13. Kayani B, Konan S, Pietrzak JR, Haddad FS. Iatrogenic bone and soft tissue trauma in robotic-arm assisted total knee arthroplasty compared with conventional jig-based total knee arthroplasty: Aprospective cohort study and validation of a new classification system. J Arthroplast 2018;33:2496-501.
14. Nicoll D, Rowley DI. Internal rotational error of the tibial component is a major cause of pain after total knee
replacement. J Bone Joint Surg Br 2010;92:1238-44.
15. Kayani B, Konan S, Pietrzak JR, Huq SS, Tahmassebi J, Haddad FS. The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty. Bone Joint J 2018;100-B:1033-42.
16. Kayani B, Konan S, Ayuob A, Onochie E, Al-Jabri T, Haddad FS. Robotic technology in total knee arthroplasty: A systematic review. EFORTOpen Rev 2019;4:611-7.
17. Clark G, Steer R, Tippett B, Wood D. Short-term benefits of robotic assisted total knee arthroplasty over computer navigated total knee arthroplasty are not sustained with no difference in postoperative patient-reported outcome measures. Arthroplast Today 2022;14:210-5.e0.
How to Cite this article: Londhe SB, Shah RV, Desouza C, Shetty V, Antao N, Patwardhan M, Kantawala S. Comparative Analysis of the Immediate Post-operative Outcomes between Conventional and Fully Automatic Robotic-assisted Total Knee Arthroplasty. Journal of Clinical Orthopaedics 2023;8(2):12-15. |
(Abstract Text HTML) (Download PDF)