Improved Patient Satisfaction Following TKA Using Intraoperative Computer Technology to Obtain Accurate Gap Balancing

Aims:Approximately 20% of patients are dissatisfied with their total knee arthroplasty (TKA). Purpose of this study was to determine if patient satisfaction could be improved following TKA using computer technology to obtain the target alignment and precisely balanced gaps.Patients & Methods:75 consecutive patients undergoing primary robotic-arm assisted TKA (RA-TKA) with real-time intraoperative alignment and gap balancing information were compared with a prospective cohort of 75 consecutive patients undergoing primary TKA with manual jig-based instruments during the same time period. There were no differences between groups with age, gender, BMI, and ASA scores. TKA’s were performed by a single surgeon using same implant design, anesthesia and surgical protocols. Patient satisfaction survey using Knee Society (KSS) and Likert scoring system was obtained at 1-year follow-up.Results:Likert scoring system demonstrated 95% of patients in the computer technology group were either very satisfied or satisfied versus 75% in the manual instruments TKA group (p=0.005) at 1-year follow-up. Second question of the KSS which deals with pain at rest was significantly better in RA-TKA group (p=0.04). Fifth question which deals with recreational activities was also significantly improved in the RA-TKA group, p=0.02. RA-TKA group had a better average overall satisfaction score of 7.1 versus 6.4 in the manual instrument group, p=0.03.Conclusion:Using intraoperative computer technology to achieve the target alignment with flexion/extension gap balancing to within 1mm, a significant improvement in patient satisfaction was demonstrated compared to TKA using conventional manual jig-based instruments.