Summary

Robotic-assisted TKA conferred a high level of satisfaction with better levels of mental health and greater satisfaction from a functionality perspective than the conventional technique in our clinical series.

Abstract

Introduction

Robotic-assisted total knee arthroplasty (TKA) has been shown to improve functional results and degree of patient satisfaction, however, the literature in this regard could be unrepresentative given that it comes mostly from Anglo-Saxon and Asian countries. To our knowledge, there is no comparative study in Latin America that evaluates satisfaction and functionality in TKA between patients operated with conventional technique (CT) versus with robotic arm assistance (RAA).

Objective

Perform a comparative analysis of satisfaction and self-reported functional parameters between patients who underwent total knee arthroplasty with CT versus RAA.

Methods

Comparative study of a consecutive prospective historical cohort of 54 patients with severe symptomatic knee osteoarthritis, who underwent TKA with CT (18 patients) and with RAA-MAKO (36 patients), in the same center, between October 2018 and July 2020. All patients were operated on with the same type of prosthesis (Triathlon Stryker) and received the same rehabilitation program. Demographic data was recorded. Satisfaction and expectations were evaluated by a specific survey (SS) in the process of validation and functionality by patient-reported outcomes (PROMs): (1) Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), (2) 12-item Short Form Survey (SF-12, mental and physical subdivision) and (3) Hospital Anxiety and Depression Scale (HADS) at preoperative and 1-year follow-up.
Statistical analysis included t-student, Fisher's exact test and Poisson, for significance of 5% (p<0.05). A post hoc analysis was performed for each survey, showing a statistical power greater than 80%.

Results

The groups were comparable in age (mean 67 years), gender, marital status, comorbidities, mood disorders, sports played, previous surgeries and laterality (p>0.05).
In the SF-12 mental subdivision survey, there were no statistically significant differences within each group or when comparing both. The CT and RAA groups improved their score on the KOOS-JR survey at one year of follow-up, with a trend towards greater improvement in the RAA group (p=0.12). Physical subdivision on the SF-12 was significantly higher at 1-year follow-up in the RAA group (p=0.03), as was the HADS survey (p=0.04). All patients achieved high levels of satisfaction, with an average of 89.6% (22.4/25 points).

Conclusions

Robotic-assisted TKA conferred a high level of satisfaction with better levels of mental health and greater satisfaction from a functionality perspective than the conventional technique in this clinical series.