13^th International Conference on
Arthroplasty

Biography:

Dr. Bertrand Kaper has been an orthopedic surgeon in Arizona since 1999 Dr. Kaper is a fellowship-trained joint replacement surgeon, specializing in treating hip pain, knee pain, and shoulder pain. He has vast clinical experience, having performed more than 10,000 surgeries. He is an attending surgeon and chairman of the Section of Orthopaedic Surgery at HonorHealth Scottsdale – Thompson Peak in Scottsdale. He also maintains consulting privileges at Yavapai Regional Medical Center in Prescott. r. Kaper serves as a Clinical Assistant Professor at Midwestern University, Arizona College of Osteopathic Medicine in Glendale, AZ. Dr. Kaper has authored numerous peer-reviewed journal articles and is a regular presenter at scientific and medical conferences. As part of his commitment to the advancement of orthopedic surgery, he is a frequent faculty teacher at national orthopedic meetings – educating other orthopedic surgeons in the techniques of Direct Anterior THA and minimally invasive, robotic partial knee replacement. Dr. Kaper is also the founder and chairman of the board for Operation Walk International, a 501(c)3 non-profit charitable organization. This organization is dedicated to providing free hip and knee replacement surgery to patients in underdeveloped countries.

Abstract:

Introduction:

Surgical outcome analysis has shifted from surgeon- to patient-reported outcome measures (PROM).  High rates of dissatisfaction (13-20%) in PROM after TKA have persisted despite significant advances in pain-management, implant design and introduction of newer surgical techniques.  The NAVIO robotic-assisted TKA (RA-TKA) was introduced in May 2017 as an integrative approach to planning, execution and evaluation in TKA surgery. 

The goal of this study was to assess differences PROM scores between conventional instrumented TKA (CI-TKA) and RA-TKA.

Methods:

Starting in December 2016, prospective data collection of PROM’s was initiated in a single-surgeon total joint arthroplasty registry. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was collected for all patients pre-operatively, at three months post-operatively and annually thereafter.

In Group A, from December 2015 through May 2017, patients were treated with CI-TKA instrumentation.  In Group B, from June 2017 through December 2018, surgery was performed with the NAVIO RA-TKA technique.

The Journey II total knee prosthesis was used for all cases.  Peri-operative management was consistent for all patients in both groups.

Results:

A total of 696 patients underwent primary, unilateral TKA surgery during the study period.  365 patients underwent CI-TKA and 331 RA-TKA.  266 CI-TKA patients and 264 RA-TKA patients had a minimum 3 month follow up. 229 CI-TKA and 146 RA-TKA had minimum one year follow up.

The results showed a trend toward higher scores for RA-TKA for KOOS overall (p-value = 0.16) and subspecialty scores at 1-year postop, especially for pain (p-value = 0.07), quality of life (p-value = 0.20) and Sports & Recreation (p-value = 0.23).

The change from pre-operative baseline KOOS scores in the Quality of Life subscore, at both three months and one year follow up, did reach statistical significance:  CI-TKA 32.9 and 42.5 vs. RA-TKA 36.4 and 47.4 (p=0.05).

Discussion/Conclusion:

In this preliminary study, patients undergoing RA-TKA demonstrated a trend toward higher PROM scores, especially in the KOOS overall score and sub-categories of Pain, Quality of Life and Sports and