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Lookup NU author(s): Steven Galloway, Karen Smith, Professor David Deehan
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© 2024 British Editorial Society of Bone and Joint Surgery. All rights reserved.Aims The aim was to assess whether robotic-assisted total knee arthroplasty (rTKA) had greater knee-specific outcomes, improved fulfilment of expectations, health-related quality of life (HRQoL), and patient satisfaction when compared with manual TKA (mTKA). Methods A randomized controlled trial was undertaken (May 2019 to December 2021), and patients were allocated to either mTKA or rTKA. A total of 100 patients were randomized, 50 to each group, of whom 43 rTKA and 38 mTKA patients were available for review at 12 months following surgery. There were no statistically significant preoperative differences between the groups. The minimal clinically important difference in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score was defined as 7.5 points. Results There were no clinically or statistically significant differences between the knee-specific measures (WOMAC, Oxford Knee Score (OKS), Forgotten Joint Score (FJS)) or HRQoL measures (EuroQol five-dimension questionnaire (EQ-5D) and EuroQol visual analogue scale (EQ-VAS)) at 12 months between the groups. However, the rTKA group had significantly (p = 0.029) greater improvements in the WOMAC pain component (mean difference 9.7, 95% confidence interval (CI) 1.0 to 18.4) over the postoperative period (two, six, and 12 months), which was clinically meaningful. This was not observed for function (p = 0.248) or total (p = 0.147) WOMAC scores. The rTKA group was significantly (p = 0.039) more likely to have expectation of ‘Relief of daytime pain in the joint’ when compared with the mTKA group. There were no other significant differences in expectations met between the groups. There was no significant difference in patient satisfaction with their knee (p = 0.464), return to work (p = 0.464), activities (p = 0.293), or pain (p = 0.701). Conclusion Patients undergoing rTKA had a clinically meaningful greater improvement in their knee pain over the first 12 months, and were more likely to have fulfilment of their expectation of daytime pain relief compared with patients undergoing mTKA. However, rTKA was not associated with a clinically significant greater knee-specific function or HRQoL, according to current definitions.
Author(s): Clement ND, Galloway S, Baron J, Smith K, Weir DJ, Deehan DJ
Publication type: Article
Publication status: Published
Journal: Bone and Joint Journal
Year: 2024
Volume: 106-B
Issue: 5
Pages: 450-459
Print publication date: 01/05/2024
Online publication date: 01/05/2024
Acceptance date: 02/04/2024
ISSN (print): 2049-4394
ISSN (electronic): 2049-4408
Publisher: British Editorial Society of Bone and Joint Surgery
URL: https://doi.org/10.1302/0301-620X.106B5.BJJ-2023-1196.R1
DOI: 10.1302/0301-620X.106B5.BJJ-2023-1196.R1
PubMed id: 38688485
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