title: Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial.
abstract: OBJECTIVE
  Despite reduction in radiological outliers in previous randomized trials comparing robotic-assisted versus conventional total knee arthroplasty (TKA), no differences in short-term functional outcomes were observed. The aim of this study was to determine whether there was improvement in functional outcomes and quality-of-life (QoL) measures between robotic-assisted and conventional TKA.
  
  
  METHODS
  All 60 knees (31 robotic-assisted; 29 conventional) from a previous randomized trial were available for analysis. Differences in range of motion, Knee Society (KSS) knee and function scores, Oxford Knee scores (OKS), SF-36 subscale and summative (physical PCS/mental component scores MCS) were analysed. In addition, patient satisfaction, fulfilment of expectations and the proportion attaining a minimum clinically important difference (MCID) in KSS, OKS and SF-36 were studied.
  
  
  RESULTS
  Both robotic-assisted and conventional TKA displayed significant improvements in majority of the functional outcome scores at 2 years. Despite having a higher rate of complications, the robotic-assisted group displayed a trend towards higher scores in SF-36 QoL measures, with significant differences in SF-36 vitality (p = 0.03), role emotional (p = 0.02) and a larger proportion of patients achieving SF-36 vitality MCID (48.4 vs 13.8 %, p = 0.009). No significant differences in KSS, OKS or satisfaction/expectation rates were noted.
  
  
  CONCLUSIONS
  Subtle improvements in patient QoL measures were observed in robotic-assisted TKA when compared to conventional TKA. This finding suggests that QoL measures may be more sensitive and clinically important than surgeon-driven objective scores in detecting subtle functional improvements in robotic-assisted TKA patients.
  
  
  METHODS
  II.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore. dr.lincoln.liow@gmail.com.|Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA. dr.lincoln.liow@gmail.com.
authors.forename: Ming Han Lincoln
authors.identifier: http://orcid.org/0000-0002-4496-8035
authors.initials: MHL
authors.lastname: Liow
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.
authors.forename: Graham Seow-Hng
authors.initials: GS
authors.lastname: Goh
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.
authors.forename: Merng Koon
authors.initials: MK
authors.lastname: Wong
authors.affiliation: The Orthopaedic Centre (Orchard), Mount Elizabeth Medical Centre, 3 Mount Elizabeth, #08-02, Singapore, 228510, Singapore.
authors.forename: Pak Lin
authors.initials: PL
authors.lastname: Chin
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.
authors.forename: Darren Keng-Jin
authors.initials: DK
authors.lastname: Tay
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Academia, Level 4, Singapore, 169865, Singapore.
authors.forename: Seng-Jin
authors.initials: SJ
authors.lastname: Yeo
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D011446:Prospective Studies; D011788:Quality of Life; D065287:Robotic Surgical Procedures
keywords: Functional outcomes; Minimal clinically important difference; ROBODOC; Robotic knee surgery; Robotic-assisted total knee arthroplasty