gms | German Medical Science

Objectives: The emergence of robotic surgery introduced a specialized tool aimed at enhancing the precision of knee prosthesis implantation, especially in cases demanding utmost accuracy during surgery. Despite this advancement, long-term data regarding this procedure are still scarce in current literature. Hence, this study’s objective is to carry out a 10-year follow-up on a significant number of patients who underwent robotic-assisted knee surgery, aiming to assess the implants' long term performances.

Methods: A total of 236 patients underwent knee surgeries utilizing the Mako robotic system at a single center, with participation from 10 different surgeons. The distribution of patients per surgeon was not uniform. Various implant configurations were involved, including Medial UKA, Lateral UKA, Bilateral UKA, and Bi-compartmental (UKA combined with Patellofemoral Replacement). Patient conditions were assessed using different scores (WOMAC, KSS Part 1, and KSS Function) both before surgery and at the 10-year follow-up, whenever feasible. Statistical analysis, including Normality test, Mean, and Standard Deviation, was conducted on these data. Additionally, comparisons of scores were made in terms of preoperative versus follow-up conditions and also in terms of surgeon and implant configuration.

Results and conclusion: Out of the initial pool of 236 patients, 194 were available for the 10-year follow-up, while 9 patients had passed away, 5 had undergone revision surgeries, and 24 could not be contacted. Significant increases were noted across all parameters, with WOMAC scores showing a notable rise (Pre-op Mean=47.99, StDev=9.16; Post-op Mean=94.79, StDev=8.57), as well as KSS Part 1 (Pre-op Mean=47.02, StDev=12.11; Post-op Mean=90.81, StDev=10.19), and Function (Pre-op Mean=53.43, StDev=14.01; Post-op Mean=93.30, StDev=15.55). These outcomes remained consistent irrespective of the operating surgeon (with StDev values of 2.1, 2.2, and 4.4 respectively). Bi-compartmental, Lateral UKAs, and Medial UKAs demonstrated scores approximately 14% higher than Bilateral UKAs. Nevertheless, all types of implants showcased improvements 70% higher when compared to their pre-operative scores.

Significant enhancements in long-term scores were thus evident with the robotic-assisted procedures assessed, irrespective of the operating surgeon or the type of implant utilized. Furthermore, it’s crucial to underscore both the substantial size of the patient cohort and the duration of the follow-up period.