Handheld navigation in total knee arthroplasty

Robotic-assisted unicompartmental knee arthroplasty: historical perspectives and current innovations

Robotic assisted unicompartmental knee arthroplasty (RAUKA) has emerged as a successful approach for optimizing implant positioning accuracy, minimizing soft tissue injury, and improving patient-reported outcomes. The application of RAUKA is expected to increase because of its advantages over conventional unicompartmental knee arthroplasty. This review article provides an overview of RAUKA, encompassing the historical development of the procedure, the features of the robotic arm and navigation systems, and the characteristics of contemporary RAUKA. The article also includes a comparison between conventional unicompartmental arthroplasty and RAUKA, as well as a discussion of current challenges and future advancements in the field of RAUKA.

Trends in Practice Patterns of Conventional and Computer-assisted Knee Arthroplasty: An Analysis of 570,671 Knee Arthroplasties Between 2010 and 2017

BACKGROUND

Despite advances in computer-assisted knee arthroplasty (CAKA), little is known about the uptake of this technology in recent years. We aimed to explore the utilization trends and practice variation of CAKA from 2010 to 2017 and investigate the predictors of CAKA adoption.

METHODS

Patients undergoing conventional knee arthroplasty and CAKA were identified from the states of New York and Florida's administrative databases using the International Classification of Diseases version 9 and 10 procedure codes. Quarterly proportions of CAKA were calculated over the study period, and logistic regression was used to estimate predictors of CAKA utilization.

RESULTS

Between 2010 and 2017, quarterly proportion of CAKAs increased from 4.89% in 2010Q1 to 9.45% in 2017Q3 in New York and from 4.03% in 2010Q1 to 5.73% in 2017Q3 in Florida. The general CA code was used to code most of the procedures (81%). Being Black (odds ratio [OR]: 0.63, 95% confidence interval [CI], 0.60 to 0.67), Hispanic (OR: 0.45, CI, 0.41 to 0.50), and having Medicaid coverage (OR: 0.46, CI, 0.40 to 0.53) were associated with lower likelihood of receiving CAKA in New York; similar findings were found in Florida.

CONCLUSION

Utilization of CAKA has increased substantially in both New York and Florida from 2010 to 2017; however, with most CAKAs reported using the general code, understanding adoption rates of various modalities was not possible. Black and Hispanic patients and those with Medicaid insurance are least likely to receive this high-precision technology, illustrating the presence of disparities in the adoption of CAKA.