An Early-stage Comparison of Functional Outcomes Following Robotic-assisted Versus Conventional Total Knee Arthroplasty: A Systematic Review and Meta-analysis

摘要

Introduction: Conventional total knee arthroplasty (cTKA) is used to relieve pain and restore knee function and stability. Robotic-assisted TKA (rTKA) was introduced to improve the placement of surgical implants, decrease postoperative complications, and improve implant longevity. To date, studies examining functional outcomes and patient-reported pain between rTKA and cTKA in the short-term postoperative period are limited, and a meta-analysis of such early-stage outcomes has yet to be accomplished. Our study aims to evaluate the differences in function, alignment, and pain between rTKA and cTKA within 6 months postoperatively through meta-analysis. Materials and Methods: A literature search of the PubMed and Cochrane electronic databases was performed in December 2021 with Medical Subject Headings and search terms limited to “knee replacement,” “knee arthroplasty,” and “robotic knee surgery.” Subsequent analysis was conducted on all retrieved studies written in English. Results: Thirteen clinical studies were considered for systematic review, of which nine were included in meta-analysis. 1,336 cases of TKA were analyzed: RTKA ( n = 618) and cTKA ( n = 718). There were no significant differences between rTKA and cTKA in range of motion (mean difference,-0.08°; P = 0.55), functional score of the Knee Society Score (mean difference, 0.04; P = 0.78), oxford knee score (mean difference, −0.04; P = 0.81), and Functional score of the western ontario and mcmaster universities osteoarthritis index (WOMAC-F) (mean difference, −0.42; P = 0.41). There were no significant pain differences in Short Form Health Survey Bodily Pain (mean difference, −0.08; P = 0.64) and pain score of the WOMAC (WOMAC-P) (mean difference, −0.25; P = 0.47). However, rTKA subjects achieved more accurate mechanical axis alignment than cTKA subjects (mean difference, −0.50°; P < 0.01). Conclusion: Although limb alignment correction is more accurate in rTKA than cTKA, functional and pain metrics are comparable between the two procedures within 6 months’ follow-up, suggesting no added clinical benefits for rTKA versus cTKA.