Abstract
The study aims to provide an up-to-date systematic review and meta-analysis comparing
radiological and functional outcomes of total knee arthroplasty (TKA) and unicompartmental
knee arthroplasty (UKA) using either robotic assistance or conventional methods from
the latest assemblage of evidence. This study was conducted according to PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis
of Observational Studies in Epidemiology) guidelines. All studies in PubMed, EMBASE,
Medline, and Cochrane that reported radiological and functional outcomes after TKA
or UKA with either robotic or conventional methods were included in the review. Selected
endpoints for random effects, pairwise meta-analysis included operative details, radiological
outcomes (mechanical axis, component angle deviation, and outliers), and functional
outcomes (American Knee Society Score, Knee Society Function Score, revision and complication
rate, range of motion (ROM), Hospital for Special Surgery score, and Western Ontario
and McMaster Universities Osteoarthritis Index). A total of 23 studies comprising
2,765 knees were included from the initial search. Robot-assisted TKA and UKA were
associated with significantly better component angle alignment accuracy (low-to-high
quality evidence) at the cost of significantly greater operation time. Robot-assisted
UKA was found to have significantly better short-term functional outcomes compared
with conventional UKA (moderate-to-high quality evidence). Robot-assisted TKA, however,
did not exhibit significantly better short- and midterm subjective knee outcome scores
compared with its conventional counterpart (high-quality evidence). Robot-assisted
TKA and UKA were associated with nonstatistically significant improved ROM and lesser
rates of revision. Robot-assisted total and unicompartmental knee arthroplasty leads
to better radiological outcomes, with no significant differences in mid- and long-term
functional outcomes compared with conventional methods for the former. Larger prospective
studies with mid- and long-term outcomes are required to further substantiate findings
from the present study.
Keywords
robot-assisted - conventional - total knee arthroplasty - unicompartmental knee arthroplasty
- functional outcomes - radiological outcomes
