Comparison of learning curves and short-term outcomes: ROSA versus MAKO robotic-assisted total knee arthroplasty

Abstract

Background: With increasing total knee arthroplasty (TKA) procedures performed in the US and improved techniques, robotic-assisted TKA has become more common. While current evidence supports the MAKO robotic arm system in TKA, fewer studies exist regarding the newer ROSA knee system, its learning curve, and clinical outcomes. Methods: We retrospectively reviewed 210 consecutive robotic-assisted TKA cases (95 ROSA, 115 MAKO) performed by a single surgeon at a single institution from February 7, 2017 to April 15, 2022. Patient demographics, operative data, and post-operative complications were collected. Additionally, patient-reported outcomes (PROs) (Oxford Knee Score, SF-12 Version 1, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement) were collected preoperatively and postoperatively (6 mo and 1 y). Results: Steady state was reached at 9 cases in the ROSA group and at 6 cases in the MAKO group. The ROSA group’s operative time was statistically significantly longer than the MAKO group (97 vs. 91 mins, P =0.023). There were no significant differences between the ROSA and MAKO groups in terms of tourniquet use or patellar resurfacing. There were no statistically significant differences found between the two groups for PROs, 90-day complications, or all-time revision rates. Conclusions: ROSA and MAKO robotic-assisted total knee arthroplasty both have minimal learning curve lengths of 9 and 6 cases, respectively. There were no statistically significant differences in postoperative outcomes between the two robotic-assisted systems through 1-year post-surgery.