A comparison of robotic-assisted and manual techniques in restricted kinematically aligned total knee arthroplasty: coronal alignment improvement with no significant clinical differences.

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Abstract

[Indexed for MEDLINE] 19. J Knee Surg. 2024 Oct;37(12):864-872. doi: 10.1055/a-2343-2444. Epub 2024 Jun 12. Early Clinical and Economic Outcomes for the VELYS Robotic-Assisted Solution Compared with Manual Instrumentation for Total Knee Arthroplasty. Huang P(1), Cross M(1), Gupta A(2), Intwala D(3), Ruppenkamp J(2), Hoeffel D(4). Author information: (1)OrthoIndy, Indianapolis, Indiana. (2)Epidemiology and Real-World Data Sciences, Johnson and Johnson MedTech, New Brunswick, New Jersey. (3)DePuy Synthes Digital, Robotics and Emerging Channels, Raynham, Massachusetts. (4)DePuy Synthes, Medical Affairs, Palm Beach Gardens, Florida. Robotic-assisted total knee arthroplasty (TKA) has been developed to improve functional outcomes after TKA by increasing surgical precision of bone cuts and soft tissue balancing, thereby reducing outliers. The DePuy Synthes VELYS robotic-assisted solution (VRAS) is one of the latest entrants in the robotic TKA market. Currently, there is limited evidence investigating early patient and economic outcomes associated with the use of VRAS. The Premier Healthcare Database was analyzed to identify patients undergoing manual TKA with any implant system compared with a cohort of robotic-assisted TKAs using VRAS between September 1, 2021 and February 28, 2023. The primary outcome was all-cause and knee-related all-setting revisits within 90-day post-TKA. Secondary outcomes included number of inpatient revisits (readmission), operating room time, discharge status, and hospital costs. Baseline covariate differences between the two cohorts were balanced using fine stratification methodology and analyzed using generalized linear models. The cohorts included 866 VRAS and 128,643 manual TKAs that had 90-day follow-up data. The rates of both all-cause and knee-related all-setting follow-up visits (revisits) were significantly lower in the VRAS TKA cohort compared with the manual TKA cohort (13.86 vs. 17.19%; mean difference [MD]: -3.34 [95% confidence interval: -5.65 to -1.03] and 2.66 vs. 4.81%; MD: -2.15 [-3.23 to -1.08], respectively, p-value