American Association of Hip and Knee Surgeons11.12.20
A presentation at the 30th AAHKS Annual Meeting reported on a study determining whether robotic-assisted total knee arthroplasty (R-TKA) showed evidence of improvement in minimal clinically important differences (MCID) in early and intermittent patient-reported outcomes in comparison to manual total knee arthroplasty (M-TKA).
Researchers reviewed a database of 1,158 patients undergoing R-TKA (255) and M-TKA (899) over a two-year period at a tertiary medical center. The primary outcomes consisted of Knee Injury and Osteoarthritis Outcome Score (KOOS-JR) and Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Measures of Physical Health (PH) and Mental Health (MH). Statistical analysis included MCID via the distribution method and chi-square analysis to evaluate postoperative MCID.
Lead author, Jonathan H. Shaw, M.D., and co-authors, Kevin Lindsay-Rivera, M.D., Patrick Buckley, BS, Robb M. Weir, M.D., Trevor R. Banka, M.D., and Jason J. Davis, M.D., found that early—four-week—outcomes yielded similar PROMIS MCID achievement for both R-TKA and M-TKA, with mean favoring the M-TKA for KOOS-JR but did not hold up with multivariate analysis. Achievement of MCID at the six-month point also revealed no differences. At the mid-year point of recovery, a mean comparison favored R-TKA for PROMIS-MH, but there was no difference for KOOS-JR or PROMIS-PH.
The study concluded that R-TKA demonstrated comparable improvement to M-TKA in these outcome measures. Conflicting results demonstrate that confounding variables such as surgeon technique, implant fixation, and responsiveness of an outcome measure may be as important as simply what tools are used in surgery.
The study abstract can be found here.
Researchers reviewed a database of 1,158 patients undergoing R-TKA (255) and M-TKA (899) over a two-year period at a tertiary medical center. The primary outcomes consisted of Knee Injury and Osteoarthritis Outcome Score (KOOS-JR) and Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Measures of Physical Health (PH) and Mental Health (MH). Statistical analysis included MCID via the distribution method and chi-square analysis to evaluate postoperative MCID.
Lead author, Jonathan H. Shaw, M.D., and co-authors, Kevin Lindsay-Rivera, M.D., Patrick Buckley, BS, Robb M. Weir, M.D., Trevor R. Banka, M.D., and Jason J. Davis, M.D., found that early—four-week—outcomes yielded similar PROMIS MCID achievement for both R-TKA and M-TKA, with mean favoring the M-TKA for KOOS-JR but did not hold up with multivariate analysis. Achievement of MCID at the six-month point also revealed no differences. At the mid-year point of recovery, a mean comparison favored R-TKA for PROMIS-MH, but there was no difference for KOOS-JR or PROMIS-PH.
The study concluded that R-TKA demonstrated comparable improvement to M-TKA in these outcome measures. Conflicting results demonstrate that confounding variables such as surgeon technique, implant fixation, and responsiveness of an outcome measure may be as important as simply what tools are used in surgery.
The study abstract can be found here.
