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      Image-based robot assisted bicompartmental knee arthroplasty versus total knee arthroplasty

      research-article
      1 , 1 , * , , 1 , 1
      SICOT-J
      EDP Sciences
      Bicompartmental, Osteoarthritis, Robot-assisted, Arthroplasty

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          Abstract

          Objective: To evaluate the short-term clinical outcomes of image-based robot-assisted bicruciate retaining bicompartmental knee arthroplasty and compare it to robot-assisted total knee arthroplasty in the Indian population. Methods: Between December 2018 and November 2019, five patients (six knees) underwent robot-assisted bicompartmental knee arthroplasty (BCKA). These patients were demographically matched with five patients (six knees) who underwent robot-assisted total knee arthroplasty (TKA) during the same period. Clinical outcomes of these twelve knees were assessed in the form of knee society score (KSS) score, Oxford knee score (OKS), and forgotten joint score (FJS) after a minimum follow-up period of 25 months. The data between the two cohorts were compared and analyzed. Results: Scores obtained from both cohorts were subjected to statistical analysis. SPSS software was utilized and the Mann Whitney U-test was utilized to compare the two groups. There was no statistically significant difference found between the two groups in terms of functional outcome. Conclusion: Image-based robot-assisted BCKA is a bone stock preserving and more physiological procedure which can be a promising alternative to patients presenting with isolated arthritis of only two compartments of the knee. Although long-term, larger trials are warranted to establish it as an alternative, our pilot study shows an equally favorable outcome as TKA, making it an exciting new avenue in the field of arthroplasty.

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          Most cited references32

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          Osteoarthritis: an update with relevance for clinical practice.

          Osteoarthritis is thought to be the most prevalent chronic joint disease. The incidence of osteoarthritis is rising because of the ageing population and the epidemic of obesity. Pain and loss of function are the main clinical features that lead to treatment, including non-pharmacological, pharmacological, and surgical approaches. Clinicians recognise that the diagnosis of osteoarthritis is established late in the disease process, maybe too late to expect much help from disease-modifying drugs. Despite efforts over the past decades to develop markers of disease, still-imaging procedures and biochemical marker analyses need to be improved and possibly extended with more specific and sensitive methods to reliably describe disease processes, to diagnose the disease at an early stage, to classify patients according to their prognosis, and to follow the course of disease and treatment effectiveness. In the coming years, a better definition of osteoarthritis is expected by delineating different phenotypes of the disease. Treatment targeted more specifically at these phenotypes might lead to improved outcomes. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up

            Summary Background Knee replacements are the mainstay of treatment for end-stage osteoarthritis and are effective. Given time, all knee replacements will fail and knowing when this failure might happen is important. We aimed to establish how long a knee replacement lasts. Methods In this systematic review and meta-analysis, we searched MEDLINE and Embase for case series and cohort studies published from database inception until July 21, 2018. Articles reporting 15 year or greater survival of primary total knee replacement (TKR), unicondylar knee replacement (UKR), and patellofemoral replacements in patients with osteoarthritis were included. Articles that reviewed specifically complex primary surgeries or revisions were excluded. Survival and implant data were extracted, with all-cause survival of the knee replacement construct being the primary outcome. We also reviewed national joint replacement registry reports and extracted the data to be analysed separately. In the meta-analysis, we weighted each series and calculated a pooled survival estimate for each data source at 15 years, 20 years, and 25 years, using a fixed-effects model. This study is registered with PROSPERO, number CRD42018105188. Findings From 4363 references found by our initial search, we identified 33 case series in 30 eligible articles, which reported all-cause survival for 6490 TKRs (26 case series) and 742 UKRs (seven case series). No case series reporting on patellofemoral replacements met our inclusion criteria, and no case series reported 25 year survival for TKR. The estimated 25 year survival for UKR (based on one case series) was 72·0% (95% CI 58·0–95·0). Registries contributed 299 291 TKRs (47 series) and 7714 UKRs (five series). The pooled registry 25 year survival of TKRs (14 registries) was 82·3% (95% CI 81·3–83·2) and of UKRs (four registries) was 69·8% (67·6–72·1). Interpretation Our pooled registry data, which we believe to be more accurate than the case series data, shows that approximately 82% of TKRs last 25 years and 70% of UKRs last 25 years. These findings will be of use to patients and health-care providers; further information is required to predict exactly how long specific knee replacements will last. Funding The National Joint Registry for England, Wales, Northern Ireland, and Isle of Man and the Royal College of Surgeons of England.
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              Gait analysis of patients following total knee replacement: a systematic review.

              Gait analysis has been used to objectively measure patients' function following total knee replacement (TKR). Whilst the findings of this research may have important implications for the understanding of the outcomes of TKR, the methodology of existing research appears to be diverse and many of the results inconsistent. The objective of this systematic review was to synthesise reported findings and to summarise the methods used by researchers in this field. Eleven articles published in the medical literature that used gait analysis to compare patients following TKR with controls were identified for inclusion in this review. Each article was assessed for methodologic quality and data was compared across studies through the calculation of effect sizes. Consistently large effect sizes showed that patients following TKR walk with less total knee motion during gait and with less knee flexion during swing than controls. Kinetic discrepancies between patients and controls were also identified. The substantial methodologic differences between studies may contribute to the inconsistencies in reported findings for many gait outcomes. Future research is needed to determine the clinical relevance of these findings.
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                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2022
                16 December 2022
                : 8
                : 48
                Affiliations
                Department of Orthopaedics, Amrita Institute of Medical Sciences Kochi 682041 Kerala India
                Author notes
                [* ]Corresponding author: srivatsan@ 123456aims.amrita.edu
                Author information
                http://orcid.org/0000-0002-0870-223X
                http://orcid.org/0000-0003-4700-8862
                Article
                sicotj220055 10.1051/sicotj/2022048
                10.1051/sicotj/2022048
                9879145
                36648272
                ab260179-d915-4b8d-b988-947dbb9fcd0c
                © The Authors, published by EDP Sciences, 2022

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 November 2022
                : 20 November 2022
                Page count
                Figures: 3, Tables: 5, Equations: 0, References: 31, Pages: 6
                Categories
                Original Article
                Knee

                bicompartmental,osteoarthritis,robot-assisted,arthroplasty

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