674 The Use of MAKO CT-Based Robotic-Assisted System for Total Knee Arthroplasty Compared to Conventional Total Knee Arthroplasty: A Systematic Review

Abstract

Aim
This study aims to investigate the differences between the MAKO CT-based robotic-assisted system and the conventional technique for TKA, focusing on assessing patient outcomes, surgical time and costs.

Background
Total knee arthroplasty (TKA) is a surgical procedure that replaces a damaged knee joint. The conventional method involves surgically removing the damaged knee joint and replacing it with an implant. In contrast, the MAKO system TKA is an amalgamation of robotic surgery with a CT-based 3D model of the patient’s knee.

Method
A PRISMA systematic review was conducted using 4 databases (Cochrane, Google Scholar, OVID and Pubmed) to identify all studies that reported the use and results of the CT-based robotic-assisted system to perform TKA. The outcome criteria investigated included patient-reported scores, implant alignment, analgesia requirements, estimated blood loss, surgical time, operation time, tourniquet time, implant thickness variations, and length of hospital stay.

Results
141 studies were identified, of which 17 met the inclusion criteria. Of those, 13 were included in this study. The MAKO CT-based robotic-assisted system, compared to conventional methods for TKA, resulted in similar patient outcomes, higher implant precision, lower analgesia requirements, lower blood loss, longer operation time, longer tourniquet time, lower implant thickness, and shorter hospital stays. Due to several factors, the cost of the MAKO CT-based robotic-assisted system for TKA could be less than that of conventional TKA.

Conclusions
The MAKO CT-based robotic-assisted system for TKA does not lead to different patient outcomes but should be considered in practice in light of other supporting parameters improving surgical care.