Trends in Utilization of Technology-Assisted Navigation in Unicompartmental and Total Knee Arthroplasty Between 2009 and 2022.

Abstract

In cases of isolated, single-compartment osteoarthritis of the knee, both unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be effective treatment options. This study evaluated rates of technology-assisted utilization in UKA (TA-UKA) using a national claims database over a contemporary 13-year period to determine the trends in use of TA-UKA relative to TKA in the United States. Patients undergoing primary UKA and TKA from 2009 to 2022 were identified using a large national claims database. Rates of computer and robotic assistance were then determined to ascertain trends in technology-assisted TKA (TA-TKA) and TA-UKA over the study period. Technology assistance was defined as computer navigation or robotics. Utilization trends were also stratified by sex, region, and age, and significance was determined using Mann-Kendall statistical tests. Between 2009 and 2022, 71,396 patients underwent UKA, while 869,794 patients underwent primary TKA. The rate of TA-UKA cases increased by 17.3% from 2009 to 2022 (P < 0.001), while rates of TA-TKA procedures increased by 10.8% (P < 0.001). Higher volumes of TA-UKA cases were performed in urban areas and on women. By 2022, 20.6% of all UKA cases and 17.6% of all TKA cases were performed with technology. While a significant increase in the rates of both TA-UKA and TA-TKA cases was observed, there was a greater increase in use for UKA relative to TKA, potentially due to the greater precision of implant positioning needed during UKA and existing data supporting its use. Despite increases in the usage of technology over time, the majority of both UKA and TKA in the United States are not performed with technology. Further evidence is needed to elucidate whether the use of technology assistance for UKA yields superior surgical and patient outcomes.