Unicompartmental knee arthroplasty (UKA) utilization has steadily increased in the United States, riding alongside an explosive parallel surge in the adoption of automated robotic platforms. This technological wave is aggressively pushed by claims that manual unicompartmental knee arthroplasty (MUKA) is plagued by high error rates for implant positioning, structural alignment outliers, and compromised long-term survivorship. Two recent high-profile reports by Kazarian et al shockwaves through the arthroplasty community, demonstrating that manual surgeons failed to meet basic implant positioning targets in a staggering 88.1% of cases, resulting in an unacceptable 14.2% all-cause revision rate.
However, these reports failed to account for a critical clinical variable: the baseline caseload and execution of a dedicated, high-volume partial knee specialist. Because faithful scientific replication is essential for establishing the generalizability of status-quo-defining peer-reviewed literature, we set out to determine if this historical robotic dogma holds true when evaluated against an experienced manual reconstruction surgeon.
