A single rate meta-analysis of postoperative complications in robot arm-assisted unicompartmental knee arthroplasty / 中华创伤骨科杂志

ABSTRACT

Objective:To observe the postoperative complications and revision rates of robot arm-assisted unicompartment arthroplasty by means of a meta-analysis.Methods:Relevant databases including Cochrane Library, PubMed, EMBASE, Wanfang, VIP, CNKI, and Web of Science were searched by computer for high-quality studies on complications and revision rates after robot arm-assisted unicompartment arthroplasty in both English and Chinese from the database establishment date to March 2021. The quality of the studies retrieved was evaluated. Relevant data including postoperative complications, infection, pain, prosthesis loosening, and revision were extracted for a meta-analysis using STATA 15.0 software.Results:A total of 16 studies were included, including one randomized controlled study, 6 case-control studies and 9 cohort studies. By the methodological index for non-randomized studies (MINORS), 7 studies scored 14 points, 3 studies 13 points, one study 12 points, 4 studies 11 points, and one study 10 points. Meta analysis showed that the total rate of complications was 2% (95% CI 1%to 4%) . Three studies used NAVIO robot, 7 studies MAKO robot, one study NAVIO and MAKO robots, and one study Acrobot robot. Since just one study used Acrobot robot, only MAKO and NAVIO robots were included for the subgroup analysis which showed that the postoperative complication rates for NAVIO and MAKO robots were 4.0% (95% CI -2% to 10%) and 3% (95% CI 1% to 5%) , respectively. The incidence of postoperative pain was 0.2% (95% CI 0.1% to 0.3%), the incidence of postoperative infection 0.5% (95% CI 0.3% to 0.8%), the incidence of postoperative prosthesis loosening 0.5% (95% CI 0.3% to 0.8%), and the revision rate 2% (95% CI 1% to 2%). According to the subgroup analysis of NAVIO and MAKO robots, their revision rates were 4% (95% CI 2% to 7%) and 2% (95% CI 1% to 2%), respectively. Conclusion:The clinical efficacy of robot arm-assisted unicompartment arthroplasty is good, for the complications in the patients are limited and the long-term survival rate of the prosthesis is excellent.