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General Orthopaedics

OUTCOMES OF 500 CONSECUTIVE ROBOT-ASSISTED UNICOMPARTMENTAL KNEE ARTHROPLASTY PROCEDURES

The International Society for Computer Assisted Orthopaedic Surgery (CAOS)



Abstract

Osteoarthritis of the knee is a debilitating condition affecting millions of persons, often requiring arthroplasty to relieve pain and improve mobility. For those patients with disease in only one compartment of the knee, unicompartmental knee arthroplasty (UKA) can be a viable surgical alternative. To date, there has not been a large series reported in the literature of UKAs performed with robotic assistance. The aim of this study was to examine the clinical outcomes of patients who underwent this procedure.

Five hundred and ten procedures in patients with a mean age of 63.7 years (range, 28 to 88 years) who underwent unicompartmental knee arthroplasty using a robotic-assisted system between July, 2008 and June, 2010 were identified. Clinical outcomes were evaluated using the Oxford Knee Score and patients without recent follow-up were contacted by telephone. The revision rate and time to revision were also examined.

The average length of stay for patients who underwent robot-assisted UKA was 1.4 days (range, 1 to 7 days). There was minimal blood loss with most procedures. At latest clinical follow-up, most patients were doing well after UKA with a mean Oxford Knee Score of 36.1 + 9.92. The revision rate was 2.5% with 13 patients being either converted from an inlay to onlay prosthesis or conversion to total knee arthroplasty. The most common indication for revision was tibial component loosening, followed by progression of arthritis. Mean time to revision was 9.55 + 5.48 months (range, 1 to 19 months).

Unicompartmental arthroplasty with a robotic system provides good pain relief and functional outcome at short-term follow-up. Ensuring correct component alignment and ligament balancing increases the probability of a favorable outcome following surgery. Proper patient selection for appropriate UKA candidates remains an important factor for successful outcomes.