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Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Despite reduction in radiological outliers in previous randomized trials comparing robotic-assisted versus conventional total knee arthroplasty (TKA), no differences in short-term functional outcomes were observed. The aim of this study was to determine whether there was improvement in functional outcomes and quality-of-life (QoL) measures between robotic-assisted and conventional TKA.

Methods

All 60 knees (31 robotic-assisted; 29 conventional) from a previous randomized trial were available for analysis. Differences in range of motion, Knee Society (KSS) knee and function scores, Oxford Knee scores (OKS), SF-36 subscale and summative (physical PCS/mental component scores MCS) were analysed. In addition, patient satisfaction, fulfilment of expectations and the proportion attaining a minimum clinically important difference (MCID) in KSS, OKS and SF-36 were studied.

Results

Both robotic-assisted and conventional TKA displayed significant improvements in majority of the functional outcome scores at 2 years. Despite having a higher rate of complications, the robotic-assisted group displayed a trend towards higher scores in SF-36 QoL measures, with significant differences in SF-36 vitality (p = 0.03), role emotional (p = 0.02) and a larger proportion of patients achieving SF-36 vitality MCID (48.4 vs 13.8 %, p = 0.009). No significant differences in KSS, OKS or satisfaction/expectation rates were noted.

Conclusion

Subtle improvements in patient QoL measures were observed in robotic-assisted TKA when compared to conventional TKA. This finding suggests that QoL measures may be more sensitive and clinically important than surgeon-driven objective scores in detecting subtle functional improvements in robotic-assisted TKA patients.

Level of evidence

II.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore

    Ming Han Lincoln Liow, Graham Seow-Hng Goh, Merng Koon Wong, Darren Keng-Jin Tay & Seng-Jin Yeo

  2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    Ming Han Lincoln Liow

  3. The Orthopaedic Centre (Orchard), Mount Elizabeth Medical Centre, 3 Mount Elizabeth, #08-02, Singapore, 228510, Singapore

    Pak Lin Chin

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  1. Ming Han Lincoln Liow
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Correspondence to Ming Han Lincoln Liow.

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Liow, M.H.L., Goh, G.SH., Wong, M.K. et al. Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial. Knee Surg Sports Traumatol Arthrosc 25, 2942–2951 (2017). https://doi.org/10.1007/s00167-016-4076-3

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