Background and aims Unicompartmental knee arthroplasty (UKA) is a popular bone-preserving and ligament-preserving alternative to total knee arthroplasty (TKA) for isolated medial compartment osteoarthritis (OA). Robotic assistance aims to improve implant positioning accuracy and potentially reduce complications, although the evidence remains inconsistent across prior systematic reviews and meta-analyses. This review synthesizes evidence from existing systematic reviews and meta-analyses comparing robotic-assisted versus conventional UKA (C-UKA), focusing on complication rates and a revised meta-analysis is performed to determine whether robotics reduces complications. Methods This overview followed the Cochrane Handbook guidelines and was prospectively registered with PROSPERO CRD420251242811. Databases (PubMed, Scopus, Cochrane Library) were searched for systematic reviews/meta-analyses comparing robotic-assisted and conventional UKA in adults. Inclusion was limited to meta-analyses reporting complications, operative time, or malalignment. The AMSTAR‑2 was used to assess review quality and the GROOVE tool to evaluate primary study overlap. A revised meta-analysis was conducted in RevMan 5.4, using random-effects and fixed-effects models as appropriate, and calculating Mantel-Haenszel odds ratios (MH-OR) for complications and mean differences in operative time. Results Five meta-analyses were included in the study. Robotic-assisted UKA (RA-UKA) achieved significantly better component positioning within safe zones (RR 1.73, 95% CI 1.12–2.69, P = 0.01). Operative time was markedly longer (MD 16.90 min, 95% CI 13.91–19.90, P < 0.0001; I 2 = 0%). No significant difference emerged in overall complications (MH-OR 0.66, 95% CI 0.34–1.29, P = 0.22; I 2 = 89%). High primary study overlap and variable review quality (AMSTAR-2: 2 low, 1 moderate, 2 high risk of bias) were noted. Publication bias was low. Conclusion The use of RA-UKA enhances positioning precision but does not significantly reduce short-term complications compared to conventional UKA, despite increased operative time. High-quality, long-term RCTs are required to evaluate revision rates, survivorship and cost-effectiveness.
Unicompartmental knee arthroplasty (UKA) is a popular bone-preserving and ligament-preserving alternative to total knee arthroplasty (TKA) for isolated medial compartment osteoarthritis (OA). Robotic assistance aims to improve implant positioning accuracy and potentially reduce complications, although the evidence remains inconsistent across prior systematic reviews and meta-analyses. This review synthesizes evidence from existing systematic reviews and meta-analyses comparing robotic-assisted versus conventional UKA (C-UKA), focusing on complication rates and a revised meta-analysis is performed to determine whether robotics reduces complications. This overview followed the Cochrane Handbook guidelines and was prospectively registered with PROSPERO CRD420251242811. Databases (PubMed, Scopus, Cochrane Library) were searched for systematic reviews/meta-analyses comparing robotic-assisted and conventional UKA in adults. Inclusion was limited to meta-analyses reporting complications, operative time, or malalignment. The AMSTAR‑2 was used to assess review quality and the GROOVE tool to evaluate primary study overlap. A revised meta-analysis was conducted in RevMan 5.4, using random-effects and fixed-effects models as appropriate, and calculating Mantel-Haenszel odds ratios (MH-OR) for complications and mean differences in operative time. Five meta-analyses were included in the study. Robotic-assisted UKA (RA-UKA) achieved significantly better component positioning within safe zones (RR 1.73, 95
Background An entire peroneus longus tendon (PLT) autograft has been introduced as an alternative graft for anterior cruciate ligament (ACL) reconstruction but concerns remain regarding donor-site effects on ankle and foot function. Objective This study evaluated knee outcome, ankle/foot function and footprint changes after ACL reconstruction using the entire peroneus longus autograft. Methods This non-randomized controlled clinical trial included 26 male patients (mean age 29.7 +/- 5.8 years) with isolated ACL tears who underwent arthroscopic ACL reconstruction using an ipsilateral entire PLT autograft at Ain Shams University Hospitals and Dar Al-Shefa Hospitals. Patients were assessed preoperatively and at 6 months using the Foot Arch Index (FAI) from static footprint analysis, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot and Ankle Disability Index (FADI) and International Knee Documentation Committee (IKDC) score. Results The FAI significantly increased from 0.26 +/- 0.05 preoperatively to 0.27 +/- 0.04 at 6 months (P = 0.027). Knee outcome improved, with the IKDC increasing from 68 +/- 0.5 to 84.0 +/- 0 (P = 0.017). Ankle/foot functional scores did not change significantly, with the AOFAS remaining at 98.8 +/- 2.31 preoperatively versus 98.8 +/- 2.45 postoperatively (P = 1) and the FADI showing no significant difference (99 +/- 1.73 vs. 99.3 +/- 1.41; P = 0.212) .Conclusion Reconstruction of the ACL using the entire PLT autograft was associated with improved knee outcome at 6 months without significant deterioration in ankle/foot function, alongside a small but statistically significant increase in FAI.
