Clinical results and patient-reported outcomes following robotic-assisted primary total knee arthroplasty (original) (raw)
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HSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery, 2021
Background: Total knee arthroplasty (TKA) demonstrates excellent durability using jig-based manual techniques (manual TKA [mTKA]), but significant rates of dissatisfaction remain. Modifications of mTKA techniques and TKA implant designs to improve outcomes have had minimal success. Studies comparing relative outcomes of mTKA and robotic-assisted TKA (raTKA) are limited. Purpose: This study sought to compare outcomes of mTKA and raTKA in patients at a single institution. Methods: We retrospectively reviewed all primary TKAs performed by 1 surgeon from 2015 to 2017. In all, 139 consecutive mTKAs (2015–2016) and 148 consecutive raTKAs (2016–2017) were included. No cases were excluded. Patient demographics, complications, readmission rates, and clinical and patient-reported outcomes were compared at a minimum of 1-year follow-up. A post hoc student t test and Pearson χ2 test were used for continuous and categorical data. Results: We found that mTKA patients compared with raTKA patients ...
A 5 year prospective study of patient-relevant outcomes after total knee replacement
Osteoarthritis and Cartilage, 2009
Objective: To prospectively describe self-reported outcomes up to 5 years after total knee replacement (TKR) in Osteoarthritis (OA) and to study which patient-relevant factors may predict outcomes for pain and physical function (PF). Methods: 102 consecutive patients with knee OA, 63 women and 39 men, mean age 71 (51e86) assigned for TKR at the Department of Orthopaedics at Lund University Hospital were included in the study. The self-administered questionnaires Knee injury and Osteoarthritis Outcome Score (KOOS) and SF-36 were mailed preoperatively and 6 months, 12 months and at 5 years postoperatively. Results: Response rate at 5 years was 86%. At 6 months significant improvement was seen in all KOOS and SF-36 scores (P < 0.001). The percentage of patients performing more demanding functions related to sports and recreation increased postoperatively. The best postoperative result was reported at the 1 year follow-up. Compared to the 1 year follow-up, a significant (P 0.01) decline was seen at 5 years in the KOOS subscale activity of daily living (ADL) function (82e73) and the SF-36 subscale bodily pain (72e63), PF (61e51) and vitality (69e59). Patients who scored in the lowest quartile preoperatively in the KOOS subscales pain and ADL made the greatest improvements to 1 year (18e82, 22e80) but also declined the most from 12 months to 5 years (82e72, 80e66). Being 10 years older pre-operatively predicted 5e7 points worse scores in KOOS pain and KOOS symptoms at 1 and 5 years. When adjusted for age, sex and comorbid conditions, pre-operative SF-36 scores did not predict postoperative KOOS pain or PF scores. Conclusion: Compared to preoperatively, a significant improvement was still seen 5 years postoperatively. However, the best result was reported at 1 year, indicating a decline from 1 to 5 years after TKR. To fully evaluate the results of TKR with regard to pain and PF, follow-ups longer than 2 years are needed, and items of more demanding PFs should be included. Older age to some extent predicted more postoperative pain and other symptoms, however, no predictors of postoperative PF were found, indicating the difficulty of determining preoperatively who will benefit more or less from the procedure.
Robotic total knee arthroplasty in clinical practice: protocol for a randomised controlled trial
Around 2–20% of patients who undergo total knee arthroplasty (TKA) reported restricted motion and anterior knee pain. Non-optimal implant components alignment represents a common cause for complain. In this context, the introduction of robotic assisted TKA is supposed to improve the accuracy of component positioning and to adapt more precisely to patient anatomy and biomechanics. Robotic TKA using has been introduced to improve component alignment, stability and proprioception. However, the advantages of robotic surgery over the conventional freehand TKA are still unclear and evidence are missing. The present study is a protocol for a single-blind parallel-group randomized controlled trial in which each group of participants is exposed to only one of the study interventions. Patients will be randomly allocated to robotic TKA or standard TKA. The primary outcome of interest is to evaluate the learning curve. The secondary outcome of interest is to compare robotic TKA using CORI versu...
Journal of clinical orthopaedics, 2023
Background: Different techniques employed during conventional and robotic-assisted total knee arthroplasty (TKA) may lead to variation in the immediate post-operative outcomes. Primary objective of the study was to evaluate the differences in post-operative pain, analgesics use, and length of stay between the robotic assisted (RA-TKA) and conventional (C-TKA). Secondary objective was to study the patient-reported outcome measures at 6-month post-TKA. Materials and Methods: It is a retrospective review of two cohorts of patients (C-TKA and RA-TKA) who were operated between January and April 2022. Patients were given the option between C-TKA and RA-TKA. Sample size was estimated to be 28 patients in each group with α error of 0.05 and power of study being 80%. An independent observer analyzed the post-operative parameters such as analgesic use, length of stay, visual analog scale (VAS) score, and Oxford Knee Score (OKS) at 6-month post-TKA. Results: 30 patients in two cohorts were studied. There was no statistically significant difference between the two cohorts as regards the pre-operative patient characteristics. RA-TKA group had a shorter hospital stay (days) than the C-TKA group (3.24 ± 0.50 and 4.07 ± 0.52, P < 0.0001). Pain score (VAS score) was lower in RA-TKA than C-TKA cohort (post-operative day [POD1] 5.23 ± 0.50 and 5.93 ± 0.52 POD2 4.40 ± 0.56 and 5.03 ± 0.49, P < 0.0001). R-TKA patients required significantly lower morphine milligram equivalent and non-steroidal anti-inflammatory drugs than the C-TKA patients (P = 0.0005 and P < 0.001, respectively). The OKS at 6 months was lower in C-TKA than RA-TKA (32.5 ± 2.3 C-TKA vs. 33.8 ± 1.5 RA-TKA, P = 0.0120). Conclusion: RA-TKA cohort showed significant early advantages such as decreased post-operative analgesia usage, shorter length of stay, and lower pain scores on days 1 and 2 than the C-TKA group. The OKS at 6 months was slightly better in RA-TKA versus C-TKA.
Knee Surgery, Sports Traumatology, Arthroscopy, 2014
Purpose Total knee arthroplasty (TKA) is a successful and safe elective operation in managing patients with severe osteoarthritis of the knee. However, the presence of residual knee pain (RKP) post-TKA can adversely affect patient satisfaction and functional outcome. Hence, the aim of this paper is to identify the incidence, progression of knee pain, functional outcome post-TKA and possible predictive factors for the development of RKP post-TKA. Methods A retrospective review of 357 patients was conducted with a minimum follow-up period of 2 years. Predictive factors reviewed include the patients' demographics, co-morbidities, type of implants and patellar management. For functional outcome, the patient's Knee Society Score (KSS) and Western Ontario and McMaster Universities Index of Osteoarthritis scores were analysed.
Cemented Total Knee Arthroplasty- A Short Term Clinical, Functional Assessment and Outcome Analysis
Journal of Evolution of Medical and Dental Sciences, 2020
BACKGROUND Total Knee Arthroplasty (TKA) has become a standard operative procedure to relieve pain, and to restore alignment and function of patients with advanced arthritis of knees. 1,2,3 Total knee arthroplasty has evolved into a very reliable surgical treatment for advanced arthritis of knee. TKA provides pain relief and improves function for patients with advanced osteoarthritis of the knee. The aim of this study is to prospectively evaluate the clinical and functional outcomes of total knee arthroplasty in arthritic knees in terms of pain relief, range of motion and stability. METHODS We prospectively reviewed a series of 65 primary Total Knee Arthroplasties performed in 40 patients at our institute from November 2014 to November 2017. Of these patients, 12 underwent bilateral TKA in the same sitting, 13 underwent staged bilateral TKA and 15 patients underwent TKA on one side. Patients were followed up to 3 years post-operatively with an average follow up of 24 months and were evaluated with Knee Society Clinical Ratings and radiographic analysis. RESULTS Pre-operative mean of clinical score (pain, ROM and stability) and functional score (walking distance and stair climbing) of patients improved from 48.33 to 92.82 and 49.65 to 88.43 respectively. CONCLUSIONS In this short-term analysis of this prospective observational study, satisfactory results were obtained in a good percentage of arthritic knee patients.
International Journal of Research in Orthopaedics, 2016
The surgical techniques has varied from soft tissue interposition arthroplasty to resection arthroplasty to surface replacement arthroplasty. In surface replacement arthroplasty different types of prosthesis were developed to address the complex knee kinematics. Total knee arthroplasty (TKA) is now a reliable treatment for severe arthritis. Various systems are available with ABSTRACT Background: Total knee arthroplasty (TKA) is now a reliable treatment for osteoarthritis. The aim of this study was to study the clinical and functional outcome of total knee arthroplasty using knee society score and to find association between knee functional score and knee clinical score. Methods: We conducted a prospective analysis of 40 cases of osteoarthritis knee patients at a tertiary care centre in Mumbai over a period of two years. Those patients who underwent total knee arthroplasty were assessed clinically and functionally using knee society score. Results: The mean preoperative knee clinical score (KCS) was 49.40±13.79 which was increased to a postoperative score of 86.08±5.64 at the end of 6 month. Similarly the mean preoperative knee functional score (KFS) was 32.75±11.79 which was increased to a postoperative score of 84.43±9.59 at the end of 6 month. There was significant increase in KCS and KFC score during follow up at 1, 3 and 6 month interval. There was significant association between knee functional score and knee clinical score at every interval. Conclusions: Total knee arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op knee clinical score and knee functional score.
Study of functional and radiological outcome of total knee arthroplasty using the knee society score
International Journal of Orthopaedics Sciences, 2017
The common causes of arthritis of the knee include Osteoarthritis (OA), Rheumatoid Arthritis (RA), Juvenile Rheumatoid Arthritis, Post traumatic Arthritis or secondary Osteoarthritis and other types of inflammatory arthritis. Osteoarthritis is thought to be the most prevalent chronic joint disease. The surgical techniques have varied from soft tissue interposition arthroplasty to resection arthroplasty to surface replacement arthroplasty. In surface replacement arthroplasty different types of prosthesis were developed to address the complex knee kinematics. Total Knee Arthroplasty (TKA) is now a reliable treatment for severe arthritis. Various systems are available with specific features regarding the geometry of the components, the degree of conformity of the articulating surface and the anchoring technique. Aim: To study the clinical, functional and radiological outcome in a consecutive series of Total Knee Arthroplasty using Knee Society Score. Materials and Methods: This study was done to analyse the clinical, functional and radiological outcome of Total Knee Arthroplasty using Knee Society score using a Posterior Cruciate substituting (Indus Knee Prosthesis). A Prospective study consisting of 30 patients who consented and underwent Total Knee Arthroplasty. The follow up period was at 3 months, 6 months and 1 year. Results and Discussion: According to the Knee Society Functional Scoring system, 30 patients were assessed in this study. 16 patients (53%) had Excellent, 11 patients (37%) had Good, 2 patients (7%) had Fair and 1 patient (3%) poor results. The results were found to be comparable with other studies. Conclusion: Total Knee Arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op Knee Clinical Score and Knee Functional Score.
Comparison of patient-reported outcome measures following total and unicondylar knee replacement
The Journal of Bone and Joint Surgery. British volume, 2012
Following arthroplasty of the knee, the patient’s perception of improvement in symptoms is fundamental to the assessment of outcome. Better clinical outcome may offset the inferior survival observed for some types of implant. By examining linked National Joint Registry (NJR) and patient-reported outcome measures (PROMs) data, we aimed to compare PROMs collected at a minimum of six months post-operatively for total (TKR: n = 23 393) and unicondylar knee replacements (UKR: n = 505). Improvements in knee-specific (Oxford knee score, OKS) and generic (EuroQol, EQ-5D) scores were compared and adjusted for case-mix differences using multiple regression. Whereas the improvements in the OKS and EQ-5D were significantly greater for TKR than for UKR, once adjustments were made for case-mix differences and pre-operative score, the improvements in the two scores were not significantly different. The adjusted mean differences in the improvement of OKS and EQ-5D were 0.0 (95% confidence interval ...