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Knee alternative expectations for surgical robots could also be misaligned, says research. Supply: Adobe Inventory
Robotically assisted whole knee arthroplasty, or TKA, has skyrocketed in recognition, however a brand new evaluation of registry information has raised some questions on the advantages of surgical robots for knee-replacement sufferers.
The evaluation of American Joint Substitute Registry (AJRR) information, offered this week at AAOS 2024 in San Francisco, discovered that revision charges had been comparable in typical and surgical robotic cementless TKA at two years post-operatively. The research additionally discovered that the chances of revision because of an infection or mechanical loosening weren’t considerably totally different between the 2 strategies.
“A variety of single-surgeon research present there’s improved precision with robotic-assisted TKA,” stated Dr. Lucas E. Nikkel, assistant professor of orthopedic surgical procedure at Johns Hopkins Medication, in a launch concerning the research. “Some research recommend there could also be improved early restoration or much less harm to mushy tissue.”
“One of many challenges with evaluating that is that many earlier research had vital monetary conflicts of curiosity with the authors,” he famous. “We wished to judge these questions utilizing a registry research to remove the potential confounding elements to know if there’s a distinction when this expertise is utilized to a surgical procedure.”
Research casts doubt on a rising market
Learning the outcomes of robotic knee procedures issues as a result of the sphere is turning into a giant enterprise. Orthopedics gadget large Stryker has been grabbing market share amid the rising recognition of its Mako robots.
Stryker ended 2023 with 60% of its knee-replacement procedures and 34% of its hip replacements within the U.S. carried out utilizing the surgical robotic. The chances had been 40% of knees and almost 20% of hips worldwide.
In recent times, rivals together with Johnson & Johnson’s DePuy Synthes enterprise, Zimmer Biomet, and Smith+Nephew have entered the market with their very own surgical robotics.
Study from Agility Robotics, Amazon, Disney, Teradyne and plenty of extra.
Surgical robotic research methodology has limitations
The researchers acknowledged some limitations to the brand new knee surgical procedure research. Nationwide registries comparable to AJRR depend on the accuracy of knowledge submitted. About 60% of the TKAs on the AJRR register didn’t report whether or not or not robotic help was used.
As well as, the research didn’t embrace youthful sufferers.
The brand new research recognized 9,220 cementless TKAs, almost half of which had been carried out with surgical robots. The outcomes — which used a multivariable, mixed-effects logistic regression mannequin with controlling for co-founders — included:
- The chances of all-cause revision at two years following surgical procedure had been comparable between the standard and robotic-assisted cohorts (odds ratio 0.8, 95% CI .05 to 1.3; p=0.4).
- The chances of revision because of an infection had been comparable between the 2 teams (OR 1.47 95% CI 0.8 to 2.6; p=0.19).
- Mechanical loosing was not considerably totally different between the cohorts (OR 3.2, 95% CI 0.8-12; p=0.09).
“Using sufferers over age 65, we anticipated them to have larger failure charges because the potential for biologic fixation could also be barely decrease,” Nikkel stated. “We discovered there was no vital variations within the danger of needing one other operation inside the first two years after surgical procedure with a robotic-assisted or guide method. That is vital on this inhabitants because the probability of an early failure is just about the identical whether or not robotic help is used or not.”
“Some sufferers want a robotic-assisted TKA as a result of they’ve heard it’s higher, however we’ve proven that there isn’t a real profit when it comes to the probability of needing one other surgical procedure within the early interval,” he stated.
Editor’s notice: This text was syndicated from The Robotic Report sibling website Medical Design & Outsourcing.
