Outcomes of Image-Free Robotic Assisted Total Knee Arthroplasty in Patients Who Have Valgus Knee Deformities

Alaka Gorur; Natalia Czerwonka; Mouhanad M El-Othmani; Michael B Held; Alexander L Neuwirth; Jeffrey A Geller

doi:10.1016/j.arth.2024.03.032

Outcomes of Image-Free Robotic Assisted Total Knee Arthroplasty in Patients Who Have Valgus Knee Deformities

J Arthroplasty. 2024 Mar 20:S0883-5403(24)00248-1. doi: 10.1016/j.arth.2024.03.032. Online ahead of print.

Authors

Alaka Gorur¹, Natalia Czerwonka¹, Mouhanad M El-Othmani¹, Michael B Held¹, Alexander L Neuwirth¹, Jeffrey A Geller¹

Affiliation

¹ Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, New York.

PMID: 38518959
DOI: 10.1016/j.arth.2024.03.032

Abstract

Background: Valgus knee deformities pose a unique challenge in total knee arthroplasty (TKA) due to the complexity of achieving ligamentous balance and satisfactory alignment compared to varus or neutral deformities. Robotic-assisted (RA) TKA could aid in achieving improved component alignment and balance.

Methods: We retrospectively evaluated a matched cohort of patients to compare image-free RA-TKA (n = 44) versus conventional manual (CM) TKA (n = 30) techniques in patients who have valgus deformity of 5 to 15 degrees, including radiographic and patient-reported outcomes measures (PROMs) over a 3-year period. The patient reported outcome measures (PROMs) studied to determine outcomes were: Western Ontario McMaster University Arthritis Index, Knee Society Score-Function Score, and Short Form 12-item Survey.

Results: Overall, the RA-TKA cohort showed faster improvement in PROMs (37.16 ± 1 8.8 versus 25.74 ± 17.7, P = .02), shorter length of stay (1.41 versus 2.29 days, P = .02), and shorter operating room times (120.79 versus 123.67 minutes, P = .02) than CM-TK). Additionally, there was no difference in the use of primary versus varus-valgus constrained polyethylene liners between the cohorts.

Conclusions: In this investigation, RA-TKA yielded a slightly faster patient recovery, more objective measurements of ligamentous balance, and proved noninferior PROMs compared to CM-TKA for preoperative valgus knee deformities.

Keywords: TKA; patient-reported outcomes; postoperative outcomes; robotic-assisted; valgus.