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Knee substitute expectations for surgical robots could also be misaligned, says research. Supply: Adobe Inventory

Robotically assisted complete knee arthroplasty, or TKA, has skyrocketed in recognition, 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 Alternative Registry (AJRR) knowledge, 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 percentages of revision attributable to 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 Drugs, in a launch concerning the research. “Some research recommend there could also be improved early restoration or much less injury to delicate tissue.”

“One of many challenges with evaluating that is that many earlier research had important monetary conflicts of curiosity with the authors,” he famous. “We needed to guage these questions utilizing a registry research to eradicate the potential confounding components to know if there’s a distinction when this know-how 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 sector is turning into an enormous enterprise. Orthopedics system big 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 odds had been 40% of knees and almost 20% of hips worldwide.

In recent times, opponents together with Johnson & Johnson’s DePuy Synthes enterprise, Zimmer Biomet, and Smith+Nephew have entered the market with their very own surgical robotics.

Be taught 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 information 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 percentages 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 percentages of revision attributable to 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 increased 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 guide method. That 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 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 by way of the probability of needing one other surgical procedure within the early interval,” he mentioned.

Editor’s notice: This text was syndicated from The Robotic Report sibling website Medical Design & Outsourcing.