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No difference in clinical outcomes between functionally aligned cruciate-retaining and posterior-stabilized robotic-assisted total knee arthroplasty

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Abstract

Purpose

To compare the clinical outcomes of subjects undergoing primary robotic-assisted total knee arthroplasty (RA-TKA), following functional alignment (FA) principles, with cruciate-retaining (CR) or posterior-stabilized (PS) bearing designs, at a minimum of 24 months of follow-up.

Methods

This observational, retrospective study included 167 consecutive patients undergoing RA-TKA with cemented PS and cementless CR implants performed with a CT-base robotic-arm assisted system (Mako, Stryker), following FA principles, between 2017 and 2020. Patients were followed up with a clinical and radiographic assessment and were administered the Forgotten Joint Score-12 (FJS-12), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), and the 5-level Likert scale (5-LLS).

Results

Three TKA revisions were performed (2 PS, 1 CR); therefore, a total of 164 knees with a mean age of 71.7 years (SD 8.9) were considered (80 cemented PS; 84 cementless CR). No statistically significant differences were recorded between study groups relative to FJS-12, KOOS-JR, and 5-LLS at a minimum of two year follow-up (FJS-12 89.3 ± 9.2 vs 87.5 ± 12.8, p-value 0.46; KOOS-JR 88.8 ± 10.0 vs 86.7 ± 14.0, p-value 0.31; 5-LLS 4.5 ± 0.7 vs 4.5 ± 0.8, p-value 0.34).

Conclusion

No significant outcome differences were reported between patients undergoing PS and CR RA-TKA at a minimum of two year follow-up. RA-TKA achieves excellent clinical results and high satisfaction scores, regardless of the implant design used.

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Data availability

The data that support the findings of this study are available from the corresponding author, VD, upon request.

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Acknowledgements

The authors would like to thank Laura Scholl, MSc for English language editing.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria Di Modena, University of Modena and Reggio-Emilia, Modena, Italy

    Valerio Daffara, Francesco Zambianchi, Gabriele Bazzan, Nikita Matveitchouk, Alessandro Berni, Laura Piacentini & Fabio Catani

  2. Department of Maternal, Child and Adult Medical and Surgical Sciences, University of Modena and Reggio-Emilia, Modena, Italy

    Riccardo Cuoghi Costantini

Authors
  1. Valerio Daffara
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  2. Francesco Zambianchi
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Contributions

V. Daffara developed the study protocol, performed data interpretation, and wrote the manuscript.

F. Zambianchi performed data interpretation and revised the manuscript critically.

G. Bazzan collected primary data.

N. Matveitchouk performed data analysis and interpretation.

A. Berni performed data analysis and interpretation.

L. Piacentini collected primary data.

R. Cuoghi Costantini performed the statistical analysis.

F. Catani generated the study hypothesis, performed data interpretation, and critically appraised the manuscript.

Corresponding author

Correspondence to Valerio Daffara.

Ethics declarations

Ethics approval

Given the retrospective and observational nature of the study, which was conducted on already available data, ethics approval was not necessary.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors Valerio Daffara, Francesco Zambianchi, Gabriele Bazzan, Nikita Matveitchouk, Alessandro Berni, Laura Piacentini, and Riccardo Cuoghi Costantini or any member of their immediate family have no funding or commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article. The author Fabio Catani reports consultancy and speaking fees, royalties, and fees for participation in review activities from Stryker.

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Daffara, V., Zambianchi, F., Bazzan, G. et al. No difference in clinical outcomes between functionally aligned cruciate-retaining and posterior-stabilized robotic-assisted total knee arthroplasty. International Orthopaedics (SICOT) 47, 711–717 (2023). https://doi.org/10.1007/s00264-023-05693-1

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