Abstract
Robotic-assisted medial unicompartmental knee arthroplasty (mUKA) has been introduced
to improve accuracy in implant positioning and limb alignment, overcoming the reported
high failure rates of conventional UKA. Indeed, mUKA is a technically challenging
procedure strongly related to surgeons' skills and expertise. The purpose of this
study was to evaluate the likelihood of robotic-assisted surgery in reducing the variability
of coronal and sagittal component positioning between high- and low-volume surgeons.
We evaluated a prospective cohort of 161 robotic mUKA implanted between May 2018 and
December 2019 at two high-volume robotic centers. Patients were divided into two groups:
patients operated by “high-volume” (group A) or “low-volume” (group B) surgeons. We
recorded intraoperative lower-limb alignment, component positioning, and surgical
timing. Postoperatively, every patient underwent a radiographical protocol to assess
coronal and sagittal femoral/tibial component alignment. Range of motion and other
clinical outcomes were assessed pre- and 12 months postoperatively by using oxford
knee score, forgotten joint score, and visual analog scale. Of 161 recruited knees,
149 (A: 101; B: 48) were available for radiographic analysis at 1 month, and clinical
evaluation at 12 months. No clinical difference neither difference in mechanical alignment
nor coronal/sagittal component positioning were found (p > 0.05). A significant difference was recorded in surgical timing (A: 57 minutes;
B: 86 minutes; p < 0.05). No superficial or deep infections or other major complications have been
developed during the follow-up. Robotics surgery in mUKA confirmed its value in improving
the reproducibility of such technical procedure, with satisfactory clinical outcomes.
Moreover, it almost eliminates any possible differences in component positioning,
and lower limb alignment among low-and high- volume knee surgeons.
Keywords
medial unicompartmental knee arthroplasty - robotic-assisted surgery - MAKOplasty
- component positioning - high- and low-volume surgeons
