Abstract
The use of technology allows increased precision in component positioning in total knee arthroplasty (TKA). The objectives of this study were to compare (1) perioperative complications, and (2) resource utilization between robotic-assisted (RA) and computer navigated (CN) versus conventional (CI) TKA.
A retrospective cohort study was performed using a national database to identify patients undergoing unilateral, primary elective TKA from January 2016 to December 2019. A total of 2,174,685 patients were identified and included RA (69,445), CN (112,225), or CI (1,993,015) TKA. Demographics, complications, lengths of stay, dispositions, and costs were compared between the cohorts. Binary logistic regression analysis was performed.
The RA TKA cohort had lower rates of intra-operative fracture (0.05 versus 0.08%, P<0.05), respiratory complications (0.6 versus 1.1%, P<0.05), renal failure (1.3 versus 1.7%, P<0.05), delirium (0.1 versus 0.2%, P<0.05), gastrointestinal (GI) complications (0.04 versus 0.09%, P<0.05), post-operative anemia (8.9 versus 13.9%, P<0.05), blood transfusion (0.4 versus 0.9%, P<0.05), pulmonary embolism (PE), and deep vein thrombosis (DVT) (0.1 versus 0.2%, P<0.05), and mortality (0.01 versus 0.02%, P<0.05) compared to conventional TKA, though the cohort did have higher rates of myocardial infarction (MI) (0.09 versus 0.07%, P<0.05). The CN cohort had lower rates of MI (0.02 versus 0.07%, P<0.05), respiratory complications (0.8 versus 1.1%, P<0.05), renal failure (1.5 versus 1.7%, P<0.05), blood transfusion (0.8 versus 0.9%, P<0.05), PE (0.08 versus 0.2%, P<0.05), and DVT (0.2 versus 0.2%, P<0.05) over CI TKA. Total cost was increased in RA (16,190 versus $15,133, P<0.05), and CN (17,448 versus $15,133, P<0.05). However, the length of hospital stay was decreased in both RA (1.8 days versus 2.2 days, P<0.05) and CN (2.1 days versus 2.2 days, P<0.05).
Technology-assisted TKA was associated with lower perioperative complication rates and faster recovery.