Table 3.
Outcomes of the included studies.
| No. | Study | PROMs |
ROM |
Radiological |
Complications | Revisions | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RATKA | CTKA | P-value | RATKA | CTKA | P-value | RATKA | CTKA | P-value | ||||
| 1 | Richards et al., 2022(CR) | KSS function: 84.1 ± 14.2 KSS knee: 92.2 ± 9.1 WOMAC: 86.7 ± 13.2 FJS: 65.4 ± 28.9 KOOS-JR: 83 ± 16.9 Satisfaction: 93.1 |
NR | NR | −2 superficial infection (managed conservatively) −10 stiffness (managed by MUA) |
Total 3: 1 instability, 1 for persistent stiffness, 1 periprosthetic fracture |
||||||
| Richards et al., 2022(PS) | KSS function: 84.3 ± 16.5 KSS knee: 89.9 ± 11.4 WOMAC: 84.6 ± 19.9 FJS: 66.3 ± 28 KOOS-JR: 83.5 ± 18 Satisfaction: 94.7 |
NR | NR | −2 superficial infection (managed conservatively) −10 stiffness (managed by MUA) |
Total 3: all were for instability | |||||||
| 2 | Z. Li et al., 2022 | KSS function: 58.2 ± 18.19 KSS knee: 70 ± 7.31 WOMAC: 80.6 ± 46.5 SF 36: 61.19 ± 19.9 HSS score: 80.1 ± 12.461 |
54.7 ± 19.52 67.8 ± 10.06 72.1 ± 44.40 63.05 ± 19.021 79.45 ± 11.52 |
0.3942 0.1107 0.2559 0.4511 0.9862 |
114.5 ± 18.41 (60–135) (Measured at 12 weeks) |
111.6 ± 18.75 (75–140) | 0.2877 | HKA: 1.8 ± 1.6 varus (0.15–7.75) | 3 ± 2.7 varus (0.2–15.15) | 0.0207 | NR | NR |
| 3 | C. Li et al., 2022 | KSS knee: 92.3 (64–99) WOMAC: 8.9 (4–22) (Measured at 90 days) |
91.8 (66–98) 8.9 (4–22) |
0.8308 0.9552 |
106 (70–120) (Measured at 90 days) |
103.5 (80–120) | 0.3613 | 21 (80.8%) patients were within ±3° | 15 (57.7%) patients were within ±3° | 0.1318 | NR | NR |
| 4 | Smith et al., 2021 | KSS function: 80 KSS knee: 85 Satisfaction 94% |
73 82 84% |
0.005 0.046 0.036 |
119 | 116 | 0.02 | NR | −9: Stiffness, all underwent MUA, 6 needed arthroscopic lysis. −2: non-fatal PE |
0 | ||
| 5 | Shaw et al., 2021 | KOOS-JR: 71.72 PROMIS: -MH:54.84 -PH: 49.43 (Measured at 8 months) |
72.08 51.64 48.62 |
0.727 0.010 0.471 |
NR | NR | NR | NR | ||||
| 6 | Samuel et al., 2021 | KOOS -pain: 42.7 ± 19.7 -PS: 26.2 ± 17.1 -KRQoL: 50.6 ± 21.9 VR-12 -MCS: 0.03 ± 9.80 -PCS: 17.8 ± 9.25 (Measured at 12 months, as differences from baseline (scaled)) |
42.2 ± 18.5 26.8 ± 16.5 47.1 ± 26.2 0.03 (9.80) 17.8 (9.25) |
0.836 0.796 0.283 0.127 0.711 |
117.8 ± 10.2 (Measured at 90 days) | 120.3 ± 9.9 | 0.043 | NR | −2 superficial infection −2 stiffness −1 DVT |
0 | ||
| 7 | Nickel et al., 2021 | KOOS-JR: 89.6 LEAS: 11.9 NPRS: 0.7 (Measured at 24 months) |
NR | HKA: 0.97 ± 1.79 (−2.4 to 3) (Measured at 12 months) |
−5 stiffness (managed by MUA) −1 patellar clunk required arthroscopy |
0 | ||||||
| 8 | Mitchell et al., 2021 | KOOS-JR: 75.8 ± 12.5 VR-12 -MCS: 55.9 ± 9.0, -PCS: 42.9 ± 9.7 UCLA: 6.1 ± 1.7 |
72.2 ± 13.7 55.4 ± 9.2 41.6 ± 10.6 5.6 ± 2.3 |
0.072 0.668 0.336 0.059 |
NR | NR | NR | 0 | ||||
| 9 | Marchand et al., 2021 | r-WOMAC -pain: 1 ± 2 (0–10) -Physical function: 2 ± 3 (0–14) -Total: 4 ± 5 (0–24) (Measured at 24 months) |
2 ± 3 (0–9) 4 ± 5 (0–28) 6 ± 7 (0–28) |
0.024 0.009 0.009 |
NR | Tibial alignment in the coronal plane was within 3° of varus and valgus in all cases | NR | −2 Stiffness: (one underwent MUA, one underwent 2 arthroscopies then poly exchange at 24 months) −1 DVT −1 PE −1 posterolateral mechanical catching underwent arthroscopic synovectomy at 13 months |
0 | |||
| 10 | Held et al., 2021 | KSS function: 75 WOMAC: -Function:87.30, -Stiffness:82.26, -Pain:90.48 SF 12: -M:44.83 -P:48.57 |
76.04 81.90 76.09 87.10 45.33 47.11 |
0.820 0.182 0.232 0.327 0.713 0.220 |
123 | 120 | 0.37 | NR | −2 Periprosthetic fracture: (one distal femoral fracture due to a fall required surgical intervention and one unicortical tibial fracture at pin site, treated conservatively) −1 aseptic loosening (stable loose lines and not revised) −10 superficial infection (3 were at pin site, treated conservatively) −2 Deep infection: treated by DAIR −1 stiffness -1 patellar tendon rupture |
NR | ||
| 11 | Blum et al., 2021 | KOOS (Measured at 24 months) -pain 46.3 ± 15.0 -Symptoms 40.3 ± 15.7 -ADL: 42.9 ± 15.4 -KRQoL 57.2 ± 18.9 -Sports and Rec: 45.2 ± 27.2 Satisfaction 100% |
139 ± 4 (Measured immediate postoperatively) | HKA: 0.8 ± 1.1 (Measured immediate postoperatively) | −2 Stiffness: managed by MUA | NR | ||||||
| 12 | Kim et al., 2020 | KSS knee: 93 ± 5 WOMAC: 18 ± 14 points UCLA: 7 points |
92 ± 6 19 ± 15 7 points |
0.321 0.981 1.000 |
125 ± 6 | 128 ± 7° | 0.321 | −86% were within ±3° of neutral mechanical alignment. -Anatomical TF angle:2 ± 2 (0–6) of valgus -TIBIA: 90 ± 1 (87–94) -FEMUR: 98 ± 2 (94–102) |
- 74% - 3 ± 3 (0–8) valgus −89 ± 6 2 (86–92) −97 ± 2 (91–101) |
−0.035 −0.897 −0.721 −0.953 |
−15 knees had aseptic loosening of the femoral and/or tibial component (the authors did not report if they were revised or not). −4 Superficial infection |
NR |
| 13 | Yeo et al., 2019(KA) | KSS function 90.1 ± 10.5 KSS (pain) 47.5 ± 5.6 WOMAC19.3 ± 1.9 HSS score 93.2 ± 8 |
125 ± 11.5 | HKA: 0.1 ± 2 TIBIA: 87.5 ± 1.7 FEMUR: 91.7 ± 1.9 |
NR | NR | ||||||
| Yeo et al., 2019 (MA) | KSS function 93 ± 9.1 KSS (pain) 47.2 ± 7.5 WOMAC20.4 ± 1.8 HSS score 94.8 5.5 |
129 ± 11.5 | HKA: − 0.3 ± 1.7 TIBIA: 90.1 ± 0.4 FEMUR: 89.5 ± 0.4 |
NR | NR | |||||||
PROMS: patient reported outcomes measures, ROM: range of motion, CR: cruciate retaining, PS: posterior stabilized, RATKA: robotic assisted total knee arthroplasty, CTKA: conventional total knee arthroplasty, KSS: knee society score, WOMAC: Western Ontario and McMaster Universities scoring systems, FJS: forgotten joint score, KOOS-JR: Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, NR: not reported, MUA: manipulation under anesthesia, SF 36: short form, HSS: Hospital for Special Surgery, HKA: hip-knee-ankle mechanical angle, PE: pulmonary embolism, PROMIS: Patient-Reported Outcomes Measurement Information System, MH: mental health, PH: physical health, KRQoL: KOOS knee–related quality-of-life sub-score, LEAS: Lower Activity Extremity Score, NPRS: Numeric Pain Rating Scale, VR-12 MCS/PCS: Veterans RAND 12-Item Health Survey–Mental Component/Physical Component Scores, UCLA: University of California at Los Angeles Activity Score, r-WOMAC: reduced Western Ontario and McMaster Universities Osteoarthritis Index, SF-12 M and P: Short Form 12 Mental and Physical scores, DAIR: debridement, antibiotics and implant retention, KA: kinematic alignment, MA: mechanical alignment. N.B. the underlined complications were directly related to the robotic machine use.