KSSTA - 2026-05-20 - Journal Article
Lateral robotic-assisted unicompartmental knee arthroplasty shows excellent early to mid-term survivorship, satisfaction and joint-specific outcome: A systematic review and meta-analysis.
Martinson ES, Williamson TR, Super JT, Oussedik S, Garner AJ, Scott CEH, Clement ND
Topics
Key Takeaway
Lateral robotic-assisted UKA achieves 98.8% survivorship at mean 53.4 months with 95.4% patient satisfaction across 971 procedures in 15 studies.
Summary Depth
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Summary
This PROSPERO-registered systematic review and meta-analysis evaluated survivorship, complications, and PROMs for lateral robotic-assisted UKA across 15 studies. Survivorship was 98.8% (95% CI 97.1–99.8) at mean 53.4 months, declining from 99.4% at ≤5 years to 97.6% at ≥5 years. KOOS improved from 43.2 to 85.9 (mean difference 42.7, p<0.001) and FJS-12 improved from 15.2 to 74.0 (mean difference 58.8, p<0.001), with gains maintained beyond 2 years.
Key Limitation
No included study directly compared robotic-assisted to conventional lateral UKA, making it impossible to attribute the outcomes to robotic assistance versus patient selection or surgical volume effects.
Original Abstract
PURPOSE
Unicompartmental knee arthroplasty (UKA) for isolated lateral compartment osteoarthritis (OA) is less common, technically demanding and is potentially associated with an increased revision risk relative to total knee arthroplasty. This review aimed to assess survivorship, complications and patient-reported outcome measures (PROMs) of robotic-assisted (RA) lateral UKA.
METHODS
A systematic review and meta-analysis were undertaken and registered with PROSPERO and followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Data search was performed through PubMed and Google Scholar in May 2025 using set search phrases. Studies in the English language relating to lateral RAUKA and commenting upon PROMs, satisfaction, survivorship and/or complications were included.
RESULTS
Fifteen studies reported the outcomes for 971 lateral RAUKAs (939 patients, 64.6% were female) with a mean follow-up of 45 months. The mean patient age was 64.2 years, and body mass index was 27.3 kg/m 2 . Eleven studies (597 patients) reported survivorship, with an overall rate of 98.8% (95% confidence interval [CI] 97.1 to 99.8) at a mean follow-up of 53.4 months, which ranged from 99.4% at ≤5 years to 97.6% at ≥5 years. Seven studies (640 patients) reported Knee Injury and Osteoarthritis Outcome Score, which improved from a mean of 43.2 preoperatively to 85.9 postoperatively (mean difference 42.7, p < 0.001), with improvements maintained beyond 2 years. Seven studies (243 patients) reported Forgotten Joint Score-12, which increased from 15.2 to 74.0 (mean difference 58.8, p < 0.001). Eight studies reported the level of satisfaction, which was 95.4% (95% CI: 92.9 to 97.4). Causes for revision included infection (n = 3), aseptic loosening (n = 1), pain (n = 4) and progression of OA in medial/patellofemoral compartments (n = 4).
CONCLUSION
Lateral RAUKA demonstrated excellent mid-term survivorship, clinically meaningful improvements in PROMs and a high level of patient satisfaction (95%). However, the available evidence was limited by modest cohort sizes, heterogeneous study designs and relatively short follow-ups, highlighting the need for larger long-term prospective studies.
LEVEL OF EVIDENCE
Level IV, systematic review and meta-analysis.