Robotic-Assisted Medial Unicompartmental Knee Arthroplasty Provides Better FJS-12 Score and Lower Mid-Term Complication Rates Compared to Conventional Implantation: A Systematic Review and Meta-Analysis.

Background: Robotic-assisted unicompartmental arthroplasty (rUKA) is gradually gaining more popularity than its conventional counterpart (cUKA). Current studies are highly heterogenic in terms of methodology and the reported results; therefore, establishing the optimal recommendation for patients becomes less straightforward. For this reason, this meta-analysis aims to provide an up-to-date evidence-based analysis on current evidence regarding clinical outcomes and complication rates following rUKA and cUKA. Methods: A meta-analysis was conducted following PRISMA guidelines. Five databases were searched, PubMed via MEDLINE, Epistemonikos, Cochrane Library, Web of Science, and Scopus. The relevant inclusion criteria were as follows: comparative clinical studies in which medial rUKA was compared to medial cUKA (prospective or retrospective designs), (2) human studies, (3) meta-analyses for cross-referencing, and (4) English language. The relevant extracted data were patient demographics, patient-reported outcome measures (PROMs), range of motion, and complications. A random-effects meta-analysis and subgroup analysis were conducted. The results include mean differences (MDs) and odds ratios (ORs), along with 95% confidence intervals (CIs) for continuous and binary variables, respectively. Results: rUKA showed a higher overall FJS-12 score compared to cUKA, with MD = 6.02 (95%CI: -0.07 to 12.1), p = 0.05. At 6 months postoperatively, the MD increased to 10.31 (95%CI: 5.14 to 15.49), p < 0.01. At a minimum 36-month follow-up, cUKA had a higher all-cause revision rate, with OR = 3.31 (95%CI: 1.25 to 8.8), p = 0.02, and at a minimum 60-month follow-up, a higher aseptic loosening rate, with OR = 3.86 (95%CI: 1.51 to 9.91), p < 0.01, compared to rUKA. Conclusions: rUKA provides better FJS-12 results compared to cUKA, as well as lower all-cause revision and aseptic loosening rates at 36- and 60-month follow-up, respectively. However, long-term follow-up is still pending.