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  • Georg Thieme Verlag KG  (3)
  • 1
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2022
    In:  The Journal of Knee Surgery Vol. 35, No. 07 ( 2022-06), p. 798-803
    In: The Journal of Knee Surgery, Georg Thieme Verlag KG, Vol. 35, No. 07 ( 2022-06), p. 798-803
    Abstract: Robotic-arm assisted total knee arthroplasty (rTKA) was developed to provide for increased accuracy of component placement compared with conventional manual TKA (mTKA). Whether or not rTKA is cost-effective in a bundled payment model has yet to be addressed. The purpose of this comparative study was to evaluate the short-term clinical outcomes of rTKA and mTKA. We retrospectively reviewed a series of 4,086 consecutive primary TKA performed by one of five surgeons across six different hospitals at our institution from January 2016 to December 2018. Outcomes for rTKA cases (n = 581) and mTKA cases (n = 3,505) were compared using unmatched multivariate analysis and a matched cohort. We analyzed 90-day outcomes, episode-of-care claims data, and short form (SF-12) outcome scores to 2 years postoperatively. In matched bivariate analysis, there was no difference in episode-of-care costs, postacute care costs, complications, 90-day readmission rates, emergency department/urgent care visits, reoperations, and mortality between rTKA and mTKA patients (p  〉  0.05). Matched patients undergoing rTKA did have a shorter hospital length of stay (1.46 vs. 1.80 days, p  〈  0.001) and decreased rates of discharge to rehabilitation facilities (5.5 vs. 14.8%, p  〈  0.001). SF-12 scores were clinically similar. Multivariate analysis demonstrated no differences in any 90-day outcome. We conclude that patients undergoing rTKA have comparable costs, 90-day outcomes, and clinically similar improvements in functional outcome scores compared with mTKA patients. Further study is needed to determine whether rTKA will result in improved implant survivorship and long-term functional outcomes (Level of evidence III).
    Type of Medium: Online Resource
    ISSN: 1538-8506 , 1938-2480
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Georg Thieme Verlag KG ; 2019
    In:  The Journal of Knee Surgery Vol. 32, No. 07 ( 2019-07), p. 600-606
    In: The Journal of Knee Surgery, Georg Thieme Verlag KG, Vol. 32, No. 07 ( 2019-07), p. 600-606
    Abstract: Total knee arthroplasty (TKA) is a highly successful operation that improves patients' quality of life and functionality. Yet, up to 20% of TKA patients remain unsatisfied with their clinical result. Robotic TKA has gained increased attention and popularity as a means of improving patient satisfaction. The promise of robotic-assisted TKA is that it provides a surgeon with a tool that accurately executes bone cuts according to presurgical planning, as well as provides the surgeon with intraoperative feedback helpful for restoring knee kinematics and soft tissue balance. Several systems are now available, each with their own advantages and disadvantages. Evidence that the use of robotics will lead to improved implant survival, function, and patient-reported outcomes is slowly being accumulated, but this has not been clearly proven to date. Recent literature does show that the use of robotics during TKA is not associated with increased surgical time or complications. The goal of this review is to provide an objective assessment of the evidence surrounding robotic technology for TKA.
    Type of Medium: Online Resource
    ISSN: 1538-8506 , 1938-2480
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2019
    Location Call Number Limitation Availability
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  • 3
    In: The Journal of Knee Surgery, Georg Thieme Verlag KG, Vol. 33, No. 07 ( 2020-07), p. 685-690
    Abstract: The purpose of this study was to perform a 3-month interim comparative analysis on outcomes between robotic-arm-assisted total knee arthroplasty (RATKA) and manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the 2011 Knee Society Scoring System. Between June 1, 2016, and March 31, 2018, 252 patients (102 manual and 150 robotic) were enrolled into a prospective, nonrandomized, open-label, multicenter comparative cohort study. Functional activity scores, patient-reported symptoms, as well as satisfaction and expectation scores were obtained from the 2011 Knee Society Scoring System preoperatively, at 4 to 6 weeks, and at 3 months postoperatively. Student's t-tests, Wilcoxon rank-sum tests, and chi-square tests with α set at 0.05 were used to compare between-group mean improvements from baseline. At 4 to 6 weeks postoperatively, RATKA patients were found to have significantly larger improvements in walking and standing (1.4 vs. –1.2 points; p = 0.019). RATKA patients were also found to have larger improvements in advanced activities (1.3 vs. 2.3 points), pain with walking (3.3 vs. 3.2 points), satisfaction score (12.4 vs. 12 points), and expectations score (5.1 vs. 4.4 points) when compared with manual TKA patients. At 3 months, RATKA patients were also found to have larger improvements in walking and standing (6.0 vs. 4.8 points), standard activities (11.4 vs. 10.1 points), advanced activities (6.2 vs. 4.6 points), functional activities total score (22.8 vs. 21.2 points), pain with walking (4.3 vs. 4.1 points), total symptoms score (10.5 vs. 10.3 points), satisfaction score (17.0 vs. 15.5 points), expectations score (4.8 vs. 4.0 points) when compared with manual TKA patients. The data indicate RATKA patients to have equal or greater improvements in 9 out of 10 of the Knee Society Scoring System components assessed at 3 months postoperatively, though not all findings were statistically significant. Since this is an early results report, this study will be continued for a longer follow-up, but we are encouraged by these interim results.
    Type of Medium: Online Resource
    ISSN: 1538-8506 , 1938-2480
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
    Location Call Number Limitation Availability
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