New Technology for Total Knee Arthroplasty Provides Excellent Patient-Reported Outcomes: A Minimum Two-Year Analysis. Malkani, A. L.; Roche, M. W.; Kolisek, F. R.; Gustke, K. A.; Hozack, W. J.; Sodhi, N.; Acuña, A.; Vakharia, R.; Salem, H. S.; Jaggard, C.; Smith, L.; and Mont, M. A. Surgical Technology International, 36:276–280, May, 2020.
abstract   bibtex   
INTRODUCTION: Robotic-assisted total knee arthroplasty has been demonstrated to help increase various patient-reported, clinical, and surgical outcome metrics (PROMs). However, the current literature is limited regarding PROMs data for longer follow-up periods beyond one year. Therefore, the purpose of this study was to 1) report multicenter patient-reported outcomes with multiple metrics, as well as 2) postoperative surgeon-specific outcomes at a minimum two-year follow-up. MATERIALS AND METHODS: Five fellowship-trained, high-volume surgeons performed a total of 188 total knee arthroplasty surgeries using the enhanced preoperative planning and real-time intraoperative feedback of a robotic-assisted device. Patients from all surgeons followed similar postoperative rehabilitation beginning on postoperative day one. Patients were evaluated based on the Short Form-12 Questionnaire (SF-12), the Forgotten Joint Score (FJS), and Knee Society total and subscores (KSS). The SF-12 was subdivided into two components: mental composite score (MCS) and physical composite score (PCS). The KSS was subdivided into functional and knee scores. Additionally, surgical outcomes from the latest follow-up visit were evaluated. All patients were evaluated at a minimum of two years follow-up time. RESULTS: All patients reported excellent postoperative outcomes for all three PROMs. The mean postoperative SF-12 MCS and PCS scores were both 57 points, with 50 as the threshold for norm-based scoring (MCS range: 42 to 69 points; PCS range: 41 to 68 points). The mean FJS was 75 points (range: 14 to 100 points). The mean KSS functional score was 84 points (range: 20 to 100) while the mean Knee Score was 92 points (range: 40 to 100). Similarly, we found that the aseptic revision rates were low (n=2, 1.06%, one for unexplained pain, and another for a post-traumatic tibial fracture) with few other postoperative complications (n=7 patients [3.7%]) in our cohort. CONCLUSION: Our analysis found that patients had excellent outcomes across multiple PROM metrics. Future work can build on these results with large patient populations over longer follow-up intervals. Nevertheless, these results provide the foundation and evidence to support the continued use of this innovative technology for total knee arthroplasties.
@article{malkani_new_2020,
	title = {New {Technology} for {Total} {Knee} {Arthroplasty} {Provides} {Excellent} {Patient}-{Reported} {Outcomes}: {A} {Minimum} {Two}-{Year} {Analysis}},
	volume = {36},
	issn = {1090-3941},
	shorttitle = {New {Technology} for {Total} {Knee} {Arthroplasty} {Provides} {Excellent} {Patient}-{Reported} {Outcomes}},
	abstract = {INTRODUCTION: Robotic-assisted total knee arthroplasty has been demonstrated to help increase various patient-reported, clinical, and surgical outcome metrics (PROMs). However, the current literature is limited regarding PROMs data for longer follow-up periods beyond one year. Therefore, the purpose of this study was to 1) report multicenter patient-reported outcomes with multiple metrics, as well as 2) postoperative surgeon-specific outcomes at a minimum two-year follow-up.
MATERIALS AND METHODS: Five fellowship-trained, high-volume surgeons performed a total of 188 total knee arthroplasty surgeries using the enhanced preoperative planning and real-time intraoperative feedback of a robotic-assisted device. Patients from all surgeons followed similar postoperative rehabilitation beginning on postoperative day one. Patients were evaluated based on the Short Form-12 Questionnaire (SF-12), the Forgotten Joint Score (FJS), and Knee Society total and subscores (KSS). The SF-12 was subdivided into two components: mental composite score (MCS) and physical composite score (PCS). The KSS was subdivided into functional and knee scores. Additionally, surgical outcomes from the latest follow-up visit were evaluated. All patients were evaluated at a minimum of two years follow-up time.
RESULTS: All patients reported excellent postoperative outcomes for all three PROMs. The mean postoperative SF-12 MCS and PCS scores were both 57 points, with 50 as the threshold for norm-based scoring (MCS range: 42 to 69 points; PCS range: 41 to 68 points). The mean FJS was 75 points (range: 14 to 100 points). The mean KSS functional score was 84 points (range: 20 to 100) while the mean Knee Score was 92 points (range: 40 to 100). Similarly, we found that the aseptic revision rates were low (n=2, 1.06\%, one for unexplained pain, and another for a post-traumatic tibial fracture) with few other postoperative complications (n=7 patients [3.7\%]) in our cohort.
CONCLUSION: Our analysis found that patients had excellent outcomes across multiple PROM metrics. Future work can build on these results with large patient populations over longer follow-up intervals. Nevertheless, these results provide the foundation and evidence to support the continued use of this innovative technology for total knee arthroplasties.},
	language = {eng},
	journal = {Surgical Technology International},
	author = {Malkani, Arthur L. and Roche, Martin W. and Kolisek, Frank R. and Gustke, Kenneth A. and Hozack, William J. and Sodhi, Nipun and Acuña, Alexander and Vakharia, Rushabh and Salem, Hytham S. and Jaggard, Charles and Smith, Langan and Mont, Michael A.},
	month = may,
	year = {2020},
	pmid = {31732961},
	keywords = {Arthroplasty, Replacement, Knee, Follow-Up Studies, Humans, Knee Joint, Knee Prosthesis, Patient Reported Outcome Measures, Range of Motion, Articular, Treatment Outcome},
	pages = {276--280}
}
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