ROBOTICS IN UNICOMPARTMENTAL KNEE ARTHROPLASTY

This statement was downgraded due to the varying treatments (robots used) between studies. Robotic technology is a significantly broad term. They can be broadly divided into haptic versus non-haptic robot. Haptic robot like MAKO assist surgeons in preparation of bone while others are an alignment guide.

Blyth (2017) demonstrated improved early functional score in robotic group. However, the study included Mako fixed bearing in robotic group and the Oxford mobile bearing knee in manual group. Pain score was significant up to eight weeks. It’s unclear if they used a tourniquet in one or both groups which may account for the difference in pain score. Few other low-quality studies (Clement 2020, Crizer 2021, Kayani 2019) demonstrated improvement in early functional score.

Zhang (2016) showed significantly better component alignment and no difference in functional score between robotic and traditional groups. In this study, coronal mechanical axis (CMA) was significantly better in robotic UKA than traditional UKA group. At 24-month follow-up, rate of outliers of 3° varus or valgus were 50% less in robotic group. Two low-quality studies (Batailler 2019, Park 2019) has shown improve the alignment in robotic group.

A moderate quality study by Gilmour (2018), there is no difference between two groups. Two other low-quality study (Hansen 2018, Wong 2019) demonstrated no difference in outcome or alignment.

Improvement in alignment and functional outcome is predominantly reported in low-quality studies. It is possible that these improvements will be demonstrated by high-quality studies in future. High quality long-term studies are needed to see if haptic technology results in better outcome.