PMID- 33692001 OWN - NLM STAT- MEDLINE DCOM- 20210630 LR - 20210630 IS - 1532-8406 (Electronic) IS - 0883-5403 (Linking) VI - 36 IP - 7S DP - 2021 Jul TI - Minimal Clinically Important Difference in Robotic-Assisted Total Knee Arthroplasty Versus Standard Manual Total Knee Arthroplasty. PG - S233-S241 LID - S0883-5403(21)00198-4 [pii] LID - 10.1016/j.arth.2021.02.038 [doi] AB - BACKGROUND: The purpose of this study was to determine whether robotic total knee arthroplasty (R-TKA) demonstrated evidence of improvement in minimal clinically important difference (MCID) in early (<4 weeks) and intermittent (4-8 month) patient-reported outcomes compared with manual total knee arthroplasty (M-TKA). METHODS: A prospectively collected database was reviewed of 1160 consecutive patients undergoing R-TKA or M-TKA from December 2017 to October 2019. Primary outcomes consisted of Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR) and Patient-Reported Outcomes Measurement Information System Global Health Measures of Physical Health (PH) and Mental Health (MH). Statistical analysis included MCID via the distribution method. RESULTS: Univariate analysis demonstrated conflicting results for early MCID achievement favoring M-TKA (4-week KOOS-JR, P = .03) for the multisurgeon cohort, but favored R-TKA (4-week Patient-Reported Outcomes Measurement Information System-PH, P = .04) in the single-surgeon analysis, and the remaining outcome scores were similar. Ultimately, multivariate analysis demonstrated similar 4-week and 6-month MCID achievement in all measures. Lower preoperative scores consistently achieved MCID at a higher rate in M-TKA, although in R-TKA, the higher baseline scores improved at a rate comparable with those with lower scores in all but the short-term postoperative KOOS-JR. CONCLUSION: R-TKA demonstrated comparable MCID achievement to M-TKA across the larger cohort. Single-surgeon comparison did show some early benefit. Confounding variables such as surgical technique, implant fixation, and responsiveness of an outcome measure may be as important as simply what tools are used during surgery. Such granular data should be sought out in future studies. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Shaw, Jonathan H AU - Shaw JH AD - Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI. FAU - Lindsay-Rivera, Kevin G AU - Lindsay-Rivera KG AD - Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI. FAU - Buckley, Patrick J AU - Buckley PJ AD - School of Medicine, Wayne State University, Detroit, MI. FAU - Weir, Robb M AU - Weir RM AD - Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI. FAU - Banka, Trevor R AU - Banka TR AD - Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI. FAU - Davis, Jason J AU - Davis JJ AD - Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, MI. LA - eng PT - Journal Article DEP - 20210218 PL - United States TA - J Arthroplasty JT - The Journal of arthroplasty JID - 8703515 SB - IM MH - *Arthroplasty, Replacement, Knee MH - Cohort Studies MH - Humans MH - Knee Joint/surgery MH - Minimal Clinically Important Difference MH - *Osteoarthritis, Knee/surgery MH - Patient Reported Outcome Measures MH - *Robotic Surgical Procedures MH - Treatment Outcome OTO - NOTNLM OT - MCID OT - minimal clinically important difference OT - postoperative outcomes OT - robotic total knee arthroplasty OT - total knee arthroplasty EDAT- 2021/03/12 06:00 MHDA- 2021/07/01 06:00 CRDT- 2021/03/11 06:01 PHST- 2020/11/30 00:00 [received] PHST- 2021/02/07 00:00 [revised] PHST- 2021/02/11 00:00 [accepted] PHST- 2021/03/12 06:00 [pubmed] PHST- 2021/07/01 06:00 [medline] PHST- 2021/03/11 06:01 [entrez] AID - S0883-5403(21)00198-4 [pii] AID - 10.1016/j.arth.2021.02.038 [doi] PST - ppublish SO - J Arthroplasty. 2021 Jul;36(7S):S233-S241. doi: 10.1016/j.arth.2021.02.038. Epub 2021 Feb 18.