Abstract
Background This study sought to evaluate the patient experience and short-term clinical outcomes
associated with the hospital stay of patients who underwent robotic arm-assisted total
knee arthroplasty (TKA). These results were compared with a cohort of patients who
underwent TKA without robotic assistance performed by the same surgeon prior to the
introduction of this technology.
Materials and Methods A cohort of consecutive patients undergoing primary TKA for the diagnosis of osteoarthritis
by a single fellowship trained orthopaedic surgeon over a 39-month period was identified.
Patients who underwent TKA during the year that this surgeon transitioned his entire
knee arthroplasty practice to robotic assistance were excluded to eliminate selection
bias and control for the learning curve. All patients received the same prosthesis
and postoperative pain protocol. Patients that required intubation for failed spinal
anesthetic were excluded. A final population of 492 TKAs was identified. Of these,
290 underwent TKA without robotic assistance and 202 underwent robotic arm-assisted
TKA. Patient demographic characteristics and short-term clinical data were analyzed.
Results Robotic arm-assisted TKA was associated with shorter length of stay (2.3 vs. 2.6
days, p < 0.001), a 50% reduction in morphine milligram equivalent utilization (from 214
to 103, p < 0.001), and a mean increase in procedure time of 9.3 minutes (p < 0.001). There was one superficial infection in the nonrobotic cohort and there
were no deep postoperative infections in either cohort. There were no manipulations
under anesthesia in the robotic cohort while there were six in the nonrobotic cohort.
Additionally, there were no significant differences in emergency department visits,
readmissions, or return to the operating room.
Conclusion This analysis corroborates existing literature suggesting that robotic arm-assisted
TKA can be correlated with improved short-term clinical outcomes. This study reports
on a single surgeon's experience with regard to analgesic requirements, length of
stay, pain scores, and procedure time following a complete transition to robotic arm-assisted
TKA. These results underscore the importance of continued evaluation of clinical outcomes
as robotic arthroplasty technology continues to grow.
Keywords
robotics - knee replacement - technology - primary knee arthroplasty
