Ten-Year Survivorship and Patient Satisfaction Following Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty

Abstract

Background: Robotic-arm-assisted unicompartmental knee arthroplasty (UKA) has been shown to result in high short- and mid-term survivorship. However, it is not known whether these outcomes are maintained at long-term follow-up. This study aimed to evaluate long-term implant survivorship, modes of failure, and patient satisfaction following robotic-arm-assisted medial UKA. Methods: A prospective multicenter study of 474 consecutive patients (531 knees) undergoing robotic-arm-assisted medial UKA was conducted. A cemented, fixed-bearing system with a metal-backed onlay tibial implant was used in all cases. Patients were contacted at 10-year follow-up to determine implant survivorship and satisfaction. Survival was analyzed using Kaplan-Meier models. Results: Data were analyzed for 366 patients (411 knees) with a mean follow-up of 10.2 ± 0.4 years. A total of 29 revisions were reported, corresponding to a 10-year survivorship of 91.7% (95% confidence interval, 88.8% to 94.6%). Of all revisions, 26 UKAs were revised to total knee arthroplasty. Unexplained pain and aseptic loosening were the most commonly reported modes of failure, accounting for 38% and 35% of revisions, respectively. Of patients without revision, 91% were either satisfied or very satisfied with their overall knee function. Conclusions: This prospective multicenter study found high 10-year survivorship and patient satisfaction following robotic-arm-assisted medial UKA. Pain and fixation failure remained common causes for revision following cemented fixed-bearing medial UKA, despite the use of a robotic-arm-assisted technique. Prospective comparative studies are needed to assess the clinical value of robotic assistance over conventional techniques in UKA. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.