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Knee substitute expectations for surgical robots could also be misaligned, says examine. Source: Adobe Stock
Robotically assisted whole knee arthroplasty, or TKA, has skyrocketed in reputation, however a brand new evaluation of registry knowledge has raised some questions on the advantages of surgical robots for knee-replacement sufferers.
The evaluation of American Joint Replacement Registry (AJRR) knowledge, introduced this week at AAOS 2024 in San Francisco, discovered that revision charges have been related in standard and surgical robotic cementless TKA at two years post-operatively. The examine additionally discovered that the chances of revision as a result of an infection or mechanical loosening weren’t considerably totally different between the 2 strategies.
“A variety of single-surgeon research present there may be improved precision with robotic-assisted TKA,” mentioned Dr. Lucas E. Nikkel, assistant professor of orthopedic surgical procedure at Johns Hopkins Medicine, in a launch concerning the examine. “Some research counsel there could also be improved early restoration or much less harm to gentle tissue.”
“One of the challenges with evaluating that is that many earlier research had important monetary conflicts of curiosity with the authors,” he famous. “We wished to guage these questions utilizing a registry examine to eradicate the potential confounding components to grasp if there’s a distinction when this know-how is utilized to a surgical procedure.”
Study casts doubt on a rising market
Studying the outcomes of robotic knee procedures issues as a result of the sector is changing into a giant enterprise. Orthopedics gadget large Stryker has been grabbing market share amid the rising reputation 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 percentages have been 40% of knees and practically 20% of hips worldwide.
In latest years, opponents together with Johnson & Johnson’s DePuy Synthes enterprise, Zimmer Biomet, and Smith+Nephew have entered the market with their very own surgical robotics.
Learn from Agility Robotics, Amazon, Disney, Teradyne and plenty of extra.
Surgical robotic examine methodology has limitations
The researchers acknowledged some limitations to the brand new knee surgical procedure examine. National registries akin to AJRR depend on the accuracy of information submitted. About 60% of the TKAs on the AJRR register didn’t report whether or not or not robotic help was used.
In addition, the examine didn’t embody youthful sufferers.
The new examine recognized 9,220 cementless TKAs, practically half of which have been carried out with surgical robots. The outcomes — which used a multivariable, mixed-effects logistic regression mannequin with controlling for co-founders — included:
- The odds of all-cause revision at two years following surgical procedure have been related between the standard and robotic-assisted cohorts (odds ratio 0.8, 95% CI .05 to 1.3; p=0.4).
- The odds of revision as a result of an infection have been related 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).
“Utilizing sufferers over age 65, we anticipated them to have greater failure charges because the potential for biologic fixation could also be barely decrease,” Nikkel mentioned. “We discovered there was no important variations within the threat of needing one other operation throughout the first two years after surgical procedure with a robotic-assisted or handbook approach. This is important 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 need 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 mentioned.
Editor’s word: This article was syndicated from The Robot Report sibling web site Medical Design & Outsourcing.
