Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis

Background: Despite increased utilization of robotic assistance during unicompartmental knee arthroplasty (UKA), its impact on postoperative outcomes remains unclear. This study aimed to compare rates of postoperative revision and complications among patients undergoing robotic-assisted UKA (RA-UKA)...

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Main Authors: George Guild, MD, Joseph Schwab, MD, Bailey J. Ross, MD, Mary Jane McConnell, BS, Farideh Najafi, MD, Thomas L. Bradbury, MD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344125000391
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author George Guild, MD
Joseph Schwab, MD
Bailey J. Ross, MD
Mary Jane McConnell, BS
Farideh Najafi, MD
Thomas L. Bradbury, MD
author_facet George Guild, MD
Joseph Schwab, MD
Bailey J. Ross, MD
Mary Jane McConnell, BS
Farideh Najafi, MD
Thomas L. Bradbury, MD
author_sort George Guild, MD
collection DOAJ
description Background: Despite increased utilization of robotic assistance during unicompartmental knee arthroplasty (UKA), its impact on postoperative outcomes remains unclear. This study aimed to compare rates of postoperative revision and complications among patients undergoing robotic-assisted UKA (RA-UKA) versus manual UKA. Methods: A retrospective matched cohort study was performed. Trends analysis of the annual proportion of RA-UKA between 2010 and 2021 was performed, and RA-UKA patients (n = 3976) were matched 1:3 with manual UKA patients (n = 11,766) across age, sex, Elixhauser Comorbidity Index, and comorbidities. Rates of 2-year prosthesis-related complications were compared between the matched cohorts using multivariable logistic regression. Results: The annual proportion of UKA procedures performed with robotic assistance trended significantly upward (1.51% to 5.19%, P < .001). Within 2 years postoperatively, the RA-UKA cohort exhibited significantly lower rates of aseptic revision (1.84% vs 2.37%; odds ratio: 0.76; P = .040) and aseptic loosening (0.13% vs 0.42%; odds ratio: 0.32; P = .010). Total cost for the index UKA was significantly higher for the RA-UKA cohort ($10,321 vs $7,366; P < .001). Conclusions: There has been a marked increase in utilization of RA-UKA. Compared to matched manual UKA, RA-UKA had lower rates of revision and aseptic loosening at 2-year follow-up, but at a higher total cost for the index procedure. Further research exploring the use of robotics in UKA with attention to patient outcomes and cost is crucial for defining its evolving role in orthopaedic surgery.
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spelling doaj-art-c62c29508dbe4ea7b408dd988a34afab2025-08-20T03:03:08ZengElsevierArthroplasty Today2352-34412025-04-013210165210.1016/j.artd.2025.101652Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort AnalysisGeorge Guild, MD0Joseph Schwab, MD1Bailey J. Ross, MD2Mary Jane McConnell, BS3Farideh Najafi, MD4Thomas L. Bradbury, MD5Total Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GA; Corresponding author. Total Joint Specialists, LLC, Northside Hospital Forsyth, 2000 Howard Farm Dr., Cumming, GA, 30041.Total Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GADepartment of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GAUniversity of Alabama at Birmingham Heersink School of Medicine, Birmingham, ALTotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GATotal Joint Specialists, LLC, Advanced Center for Joint Surgery and Northside Hospital Forsyth, Cumming, GABackground: Despite increased utilization of robotic assistance during unicompartmental knee arthroplasty (UKA), its impact on postoperative outcomes remains unclear. This study aimed to compare rates of postoperative revision and complications among patients undergoing robotic-assisted UKA (RA-UKA) versus manual UKA. Methods: A retrospective matched cohort study was performed. Trends analysis of the annual proportion of RA-UKA between 2010 and 2021 was performed, and RA-UKA patients (n = 3976) were matched 1:3 with manual UKA patients (n = 11,766) across age, sex, Elixhauser Comorbidity Index, and comorbidities. Rates of 2-year prosthesis-related complications were compared between the matched cohorts using multivariable logistic regression. Results: The annual proportion of UKA procedures performed with robotic assistance trended significantly upward (1.51% to 5.19%, P < .001). Within 2 years postoperatively, the RA-UKA cohort exhibited significantly lower rates of aseptic revision (1.84% vs 2.37%; odds ratio: 0.76; P = .040) and aseptic loosening (0.13% vs 0.42%; odds ratio: 0.32; P = .010). Total cost for the index UKA was significantly higher for the RA-UKA cohort ($10,321 vs $7,366; P < .001). Conclusions: There has been a marked increase in utilization of RA-UKA. Compared to matched manual UKA, RA-UKA had lower rates of revision and aseptic loosening at 2-year follow-up, but at a higher total cost for the index procedure. Further research exploring the use of robotics in UKA with attention to patient outcomes and cost is crucial for defining its evolving role in orthopaedic surgery.http://www.sciencedirect.com/science/article/pii/S2352344125000391Partial kneeRobotic-assistedUnicompartmental knee arthroplasty
spellingShingle George Guild, MD
Joseph Schwab, MD
Bailey J. Ross, MD
Mary Jane McConnell, BS
Farideh Najafi, MD
Thomas L. Bradbury, MD
Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
Arthroplasty Today
Partial knee
Robotic-assisted
Unicompartmental knee arthroplasty
title Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
title_full Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
title_fullStr Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
title_full_unstemmed Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
title_short Is Robotic-Assisted Unicompartmental Knee Arthroplasty Compared to Manual Unicompartmental Knee Arthroplasty Associated With Decreased Revision Rates? An Updated Matched Cohort Analysis
title_sort is robotic assisted unicompartmental knee arthroplasty compared to manual unicompartmental knee arthroplasty associated with decreased revision rates an updated matched cohort analysis
topic Partial knee
Robotic-assisted
Unicompartmental knee arthroplasty
url http://www.sciencedirect.com/science/article/pii/S2352344125000391
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