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Background <p>While robotic assistance improves precision in unicompartmental (R-UKA) and total knee arthroplasty (R-TKA), long-term comparative data are limited. This study evaluated perioperative outcomes and mid- to long-term survivorship for R-UKA versus R-TKA.</p> Methods <p>A retrospective review was performed of 163 patients who underwent primary, elective, R-UKA (<i>n</i> = 84) or R-TKA (<i>n</i> = 79) between 2011 and 2020 at a single, tertiary academic medical center, with a minimum follow-up of five years. Demographics, perioperative characteristics, and postoperative outcomes were compared between cohorts. Revision-free implant survivorship was evaluated using Kaplan–Meier analysis.</p> Results <p>R-TKA procedures had longer operative times than R-UKA (131 vs. 112.5&#xa0;min; <i>P</i> &lt; 0.001) and both were performed primarily for primary osteoarthritis. Cohorts had similar 90-day ED visit rates (3.8 vs. 4.8%; <i>P</i> = 1), for both surgical (2.5 vs. 3.6%) and medical causes (1.3 vs. 1.2%), while readmission rates were also similar (2.5 vs. 3.6%, <i>P</i> = 1). Median follow-up (9.55 vs. 6.07 years) and time since surgery (12.33 vs. 7.48 years) were significantly longer for R-UKA (both <i>P</i> &lt; 0.001). At final follow-up, revision occurred in 3.8% of R-TKA and 4.8% of R-UKA cases (<i>P</i> = 1). Time to revision was shorter for R-TKA (1.36 vs. 5.22 years; <i>P</i> = 0.114). Kaplan–Meier analysis demonstrated 5-year revision-free survivorship of 96.2% for R-TKA and 97.6% for R-UKA, with the overall log-rank test showing no significant survivorship difference between groups (<i>P</i> = 0.866).</p> Conclusions <p>In this cohort, R-UKA and R-TKA demonstrated favorable long-term survivorship with no statistically significant differences in ED visits, readmissions, or revision rates. These findings show comparable safety profiles and low revision rates at long-term follow-up for both procedures, suggesting that for patients meeting specific indications for either procedure, robotic-assisted knee arthroplasty provides durable outcomes for appropriately selected patients.</p>

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Long-term outcomes and revision-free survival following robotic-assisted unicompartmental and total knee arthroplasty

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Alexander Fleisher,
  • Mitchell Kennedy,
  • Maxwell Trudeau,
  • Diana Piergrossi,
  • Ivan Madrid,
  • Morteza Meftah

摘要

Background

While robotic assistance improves precision in unicompartmental (R-UKA) and total knee arthroplasty (R-TKA), long-term comparative data are limited. This study evaluated perioperative outcomes and mid- to long-term survivorship for R-UKA versus R-TKA.

Methods

A retrospective review was performed of 163 patients who underwent primary, elective, R-UKA (n = 84) or R-TKA (n = 79) between 2011 and 2020 at a single, tertiary academic medical center, with a minimum follow-up of five years. Demographics, perioperative characteristics, and postoperative outcomes were compared between cohorts. Revision-free implant survivorship was evaluated using Kaplan–Meier analysis.

Results

R-TKA procedures had longer operative times than R-UKA (131 vs. 112.5 min; P < 0.001) and both were performed primarily for primary osteoarthritis. Cohorts had similar 90-day ED visit rates (3.8 vs. 4.8%; P = 1), for both surgical (2.5 vs. 3.6%) and medical causes (1.3 vs. 1.2%), while readmission rates were also similar (2.5 vs. 3.6%, P = 1). Median follow-up (9.55 vs. 6.07 years) and time since surgery (12.33 vs. 7.48 years) were significantly longer for R-UKA (both P < 0.001). At final follow-up, revision occurred in 3.8% of R-TKA and 4.8% of R-UKA cases (P = 1). Time to revision was shorter for R-TKA (1.36 vs. 5.22 years; P = 0.114). Kaplan–Meier analysis demonstrated 5-year revision-free survivorship of 96.2% for R-TKA and 97.6% for R-UKA, with the overall log-rank test showing no significant survivorship difference between groups (P = 0.866).

Conclusions

In this cohort, R-UKA and R-TKA demonstrated favorable long-term survivorship with no statistically significant differences in ED visits, readmissions, or revision rates. These findings show comparable safety profiles and low revision rates at long-term follow-up for both procedures, suggesting that for patients meeting specific indications for either procedure, robotic-assisted knee arthroplasty provides durable outcomes for appropriately selected patients.