Are Rates of Inpatient Rehabilitation Reduced for Robotic Assisted Total Knee Arthroplasty Compared With Computer Navigated Total Knee Arthroplasty?

BACKGROUND

Robotic assistance and computer navigation systems are increasingly being used for total knee arthroplasty (TKA) with demonstrated improvements in early functional outcomes relative to conventional instrumentation. Patients are commonly discharged to inpatient rehabilitation following TKA with substantial associated costs to health care providers. We aimed to directly compare rates of discharge to inpatient rehabilitation between robotic assisted and computer navigated TKA to investigate differences in early functional outcomes between these technologies.

METHODS

A retrospective cohort study of patients with knee osteoarthritis undergoing computer navigated or robotic assisted primary TKA at a single institution between 01 January 2016 and 31 December 2023 was conducted. Propensity score matching was performed 1:1 with propensity scores estimated using logistic regression accounting for age, sex, body mass index, American Society of Anaesthesiologists classification, insurance status, and unilateral vs. bilateral procedure. Multivariable regression analyses were performed to evaluate differences in discharge to inpatient rehabilitation and hospital length of stay.

RESULTS

Data analyses included 1034 patients (517 matched pairs) who underwent robotic assisted, or computer navigated TKA procedures respectively. The odds of discharge to inpatient rehabilitation for robotic assisted compared to computer navigated TKA were not significantly different (odds ratio (OR) = 0.79, 95% CI 0.54-1.2, p = 0.22). A significant mean difference in acute hospital length of stay was observed (-0.42 days, 95% CI -0.73 to -0.11 days, p = 0.008) between robotic assisted compared to computer navigated TKA groups.

CONCLUSION

Robotic assisted TKA does not reduce the odds of discharge to inpatient rehabilitation but may result in significantly shorter acute hospital length of stay compared to computer navigated TKA.