Robotic Assistance in Simultaneous Bilateral Medial Unicompartmental Knee Arthroplasty: A Retrospective Cohort Study of 126 Knees Demonstrating Enhanced Radiographic Accuracy and Comparable Safety to Conventional Methods

Abstract

Background

One-stage bilateral unicompartmental knee arthroplasty (BUKA) is a promising option for patients with bilateral medial knee osteoarthritis. This study aims to compare the safety, early clinical and functional outcomes, and radiological results of conventional vs robotic-assisted medial BUKA.

Methods

A retrospective cohort study was conducted involving patients who underwent medial BUKA as a single-stage procedure between April 2016 and January 2022. The study included both conventional (36 procedures) and robotic-assisted techniques (90 procedures) with a minimum follow-up of 6 months. Conventional procedures were performed either simultaneously by two surgical teams or sequentially by one team. Robotic procedures were exclusively performed sequentially by a single team. Data on surgical outcomes, patient-reported outcome measures (International Knee Society score), and radiographic measurements were collected.

Results

Among the 63 patients analyzed, robotic-assisted procedures took significantly longer (115 ± 22 minutes) compared to conventional approaches (86.9 ± 12 minutes; P < .0001). No significant differences were observed in complications, length of hospital stay, rehospitalizations, patient-reported outcome measures, or overall clinical outcomes. However, radiographic analysis showed superior joint line restoration in the robotic group (−0.2 ± 0.7 mm vs −1.4 ± 1.35 mm, P = .03) and better tibial implant varus control (0.3° ± 0.6 vs 1° ± 1.8 degrees, P = .03).

Conclusions

While robotic-assisted BUKA resulted in longer operative times, clinical outcomes were comparable. Radiographic findings indicated improved implant positioning, suggesting potential benefits in implantation accuracy that warrant further research.

Level of Evidence

IV.