PMID- 35367335
OWN - NLM
STAT- MEDLINE
DCOM- 20220803
LR  - 20220804
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 37
IP  - 8
DP  - 2022 Aug
TI  - Navigated and Robot-Assisted Technology in Total Knee Arthroplasty: Do Outcome 
      Differences Achieve Minimal Clinically Important Difference?
PG  - 1562-1569
LID - S0883-5403(22)00377-1 [pii]
LID - 10.1016/j.arth.2022.03.075 [doi]
AB  - BACKGROUND: In total knee arthroplasty (TKA), computer-assisted navigation 
      (N-TKA) and robotic-assisted methods (RA-TKA) are intended to increase precision 
      of mechanical and component alignment. However, the clinical significance of 
      published patient-reported outcome measure (PROM) differences in comparison to 
      conventional TKA (C-TKA) is unknown. METHODS: A systematic review was performed 
      to identify all studies reporting perioperative PROMs for either primary N-TKA or 
      RA-TKA with a C-TKA comparison cohort with a minimum 1-year follow-up. Relative 
      improvements in PROMs for the two cohorts were compared to published minimal 
      clinically important difference (MCID) values. RESULTS: After systematic review, 
      21 studies (N = 3,214) reporting on N-TKA and eight studies (N = 1,529) reporting 
      on RA-TKA met inclusion criteria. Eighteen of 20 studies (90%) reported improved 
      radiographic outcomes with N-TKA relative to C-TKA; five of five studies reported 
      improved radiographic outcomes with RA-TKA relative to C-TKA. Five of 21 studies 
      (24%) reported statistically significant greater improvements in clinical PROMs 
      for N-TKA relative to C-TKA, whereas only two (10%) achieved clinical 
      significance relative to MCID on a secondary analysis. One of 8 studies (13%) 
      reported statistically significant greater improvements in PROMs for RA-TKA 
      relative to C-TKA, whereas none achieved clinical significance relative to MCID 
      on a secondary analysis. No studies reported a significant difference in revision 
      rates. CONCLUSION: While most studies comparing RA-TKA and N-TKA with C-TKA 
      demonstrate improved radiographic alignment outcomes, a minority of studies 
      reported PROM differences that achieve clinical significance. Future studies 
      should report data and be interpreted in the context of clinical significance to 
      establish patient and surgeon expectations for emerging technologies.
CI  - Copyright (c) 2022 Elsevier Inc. All rights reserved.
FAU - Arshi, Armin
AU  - Arshi A
AD  - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, 
      Pennsylvania.
FAU - Sekimura, Troy
AU  - Sekimura T
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, California.
FAU - Kelley, Benjamin V
AU  - Kelley BV
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, California.
FAU - Zeegen, Erik N
AU  - Zeegen EN
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, California.
FAU - Lonner, Jess H
AU  - Lonner JH
AD  - Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, 
      Pennsylvania.
FAU - Stavrakis, Alexandra I
AU  - Stavrakis AI
AD  - Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los 
      Angeles, California.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20220330
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - *Arthroplasty, Replacement, Knee/methods
MH  - Humans
MH  - Knee Joint/surgery
MH  - Minimal Clinically Important Difference
MH  - *Osteoarthritis, Knee/surgery
MH  - *Robotics
MH  - Treatment Outcome
OTO - NOTNLM
OT  - MCID
OT  - arthroplasty
OT  - knee
OT  - navigation
OT  - robotic
OT  - technology
EDAT- 2022/04/04 06:00
MHDA- 2022/08/04 06:00
CRDT- 2022/04/03 20:24
PHST- 2022/01/29 00:00 [received]
PHST- 2022/02/25 00:00 [revised]
PHST- 2022/03/25 00:00 [accepted]
PHST- 2022/04/04 06:00 [pubmed]
PHST- 2022/08/04 06:00 [medline]
PHST- 2022/04/03 20:24 [entrez]
AID - S0883-5403(22)00377-1 [pii]
AID - 10.1016/j.arth.2022.03.075 [doi]
PST - ppublish
SO  - J Arthroplasty. 2022 Aug;37(8):1562-1569. doi: 10.1016/j.arth.2022.03.075. Epub 
      2022 Mar 30.