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Lower Perioperative Complication Rates and Shorter Lengths of Hospital Stay Associated With Technology-Assisted Total Knee Arthroplasty Versus Conventional Instrumentation in Primary Total Knee Arthroplasty.
Constantinescu, David S; Costello, Joseph P; Yakkanti, Ramakanth R; Vanden Berge, Dennis J; Carvajal Alba, Jaime A; Hernandez, Victor H; D'Apuzzo, Michele R.
Afiliación
  • Constantinescu DS; Department of Orthopaedics, University of Miami, Miami, Florida.
  • Costello JP; Department of Orthopaedics, University of Miami, Miami, Florida.
  • Yakkanti RR; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Jefferson Health, Philadelphia, Pennsylvania.
  • Vanden Berge DJ; Department of Orthopaedics, University of Miami, Miami, Florida.
  • Carvajal Alba JA; Department of Orthopaedics, University of Miami, Miami, Florida.
  • Hernandez VH; Department of Orthopaedics, University of Miami, Miami, Florida.
  • D'Apuzzo MR; Department of Orthopaedics, University of Miami, Miami, Florida.
J Arthroplasty ; 39(6): 1512-1517, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38103801
ABSTRACT

BACKGROUND:

The use of technology allows increased precision in component positioning in total knee arthroplasty (TKA). The objectives of this study were to compare (1) perioperative complications and (2) resource utilization between robotic-assisted (RA) and computer-navigated (CN) versus conventional (CI) TKA.

METHODS:

A retrospective cohort study was performed using a national database to identify patients undergoing unilateral, primary elective TKA from January 2016 to December 2019. A total of 2,174,685 patients were identified and included RA (69,445), CN (112,225), or CI (1,993,015) TKA. Demographics, complications, lengths of stay, dispositions, and costs were compared between the cohorts. Binary logistic regression analysis was performed.

RESULTS:

The RA TKA cohort had lower rates of intraoperative fracture (0.05 versus 0.08%, P < .05), respiratory complications (0.6 versus 1.1%, P < .05), renal failure (1.3 versus 1.7%, P < .05), delirium (0.1 versus 0.2%, P < .05), gastrointestinal complications (0.04 versus 0.09%, P < .05), postoperative anemia (8.9 versus 13.9%, P < .05), blood transfusion (0.4 versus 0.9%, P < .05), pulmonary embolism, and deep vein thrombosis (0.1 versus 0.2%, P < .05), and mortality (0.01 versus 0.02%, P < .05) compared to conventional TKA, though the cohort did have higher rates of myocardial infarction (0.09 versus 0.07%, P < .05). The CN cohort had lower rates of myocardial infarction (0.02 versus 0.07%, P < .05), respiratory complications (0.8 versus 1.1%, P < .05), renal failure (1.5 versus 1.7%, P < .05), blood transfusion (0.8 versus 0.9%, P < .05), pulmonary embolism (0.08 versus 0.2%, P < .05), and deep vein thrombosis (0.2 versus 0.2%, P < .05) over CI TKA. Total cost was increased in RA (16,190 versus $15,133, P < .05) and CN (17,448 versus $15,133, P < .05). However, the length of hospital stay was decreased in both RA (1.8 versus 2.2 days, P < .05) and CN (2.1 versus 2.2 days, P < .05).

CONCLUSIONS:

Technology-assisted TKA was associated with lower perioperative complication rates and faster recovery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Artroplastia de Reemplazo de Rodilla / Procedimientos Quirúrgicos Robotizados / Tiempo de Internación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Artroplastia de Reemplazo de Rodilla / Procedimientos Quirúrgicos Robotizados / Tiempo de Internación Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos