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Knee alternative expectations for surgical robots could also be misaligned, says examine. Supply: Adobe Inventory
Robotically assisted complete 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 have been comparable in typical 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.
“Loads of single-surgeon research present there may be improved precision with robotic-assisted TKA,” stated Dr. Lucas E. Nikkel, assistant professor of orthopedic surgical procedure at Johns Hopkins Medication, in a launch in regards to the examine. “Some research recommend there could also be improved early restoration or much less harm to smooth 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 wished to judge these questions utilizing a registry examine to remove the potential confounding elements to grasp 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 sector is changing 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 have 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 lots of extra.
Surgical robotic examine methodology has limitations
The researchers acknowledged some limitations to the brand new knee surgical procedure examine. Nationwide 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.
As well as, the examine didn’t embody youthful sufferers.
The brand new examine recognized 9,220 cementless TKAs, almost 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 percentages of all-cause revision at two years following surgical procedure have 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 as a result of an infection have 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 important variations within the danger of needing one other operation throughout the first two years after surgical procedure with a robotic-assisted or handbook method. That is important on this inhabitants because the chance 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 chance of needing one other surgical procedure within the early interval,” he stated.
Editor’s notice: This text was syndicated from The Robotic Report sibling web site Medical Design & Outsourcing.