Increased accuracy in component positioning using an image-less robotic arm system in primary total knee arthroplasty: a retrospective study.

Knee alignment Knee flexion ROSA Robotic surgery Robotic-assisted total knee arthroplasty Total knee arthroplasty

Journal

Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043

Informations de publication

Date de publication:
27 Sep 2023
Historique:
received: 22 10 2022
accepted: 01 09 2023
medline: 27 9 2023
pubmed: 27 9 2023
entrez: 27 9 2023
Statut: aheadofprint

Résumé

Robotic-assisted total knee arthroplasty (RTKA) and navigated total knee arthroplasty (NTKA) have shown improved knee alignment and reduced radiographic outliers. Recent studies have proven that conventional mechanical alignment may not be the optimal goal for every patient. The aim of this study was to compare the accuracy of the planned implant positioning of a novel image-less robotic technique with an established navigated technique (NTKA). The study is a retrospective analysis of prospectively collected data that compared the implant positioning and lower-limb alignment of 86 image-less RTKA with 86 image-less NTKA. Radiographic analysis was performed to evaluate the lower-limb overall alignment, femoral and tibial components positioning in the coronal and sagittal planes. Outliers were evaluated with a cutoff of ± 3°. No difference was noted between the two groups for radiographic outliers within ± 3° from neutral (p = 0.098). The mean hip-knee-ankle angle deviation from target was 1.3° in the RTKA group compared to 1.9° in the NTKA (p < 0.001). Femoral sagittal deviation (femoral component flexion) was smaller in the RTKA group (0.9° vs 1.9°; p < 0.001). Similarly, tibial coronal deviation (0.8° vs 1.5°; p < 0.001) and tibial sagittal deviation (tibial slope) were smaller in the RTKA group compared to the NTKA group (0.9° vs 1.7°; p < 0.001). The RTKA group reported a substantial and significant reduced error from the planned target angles for both tibial and femoral components. No difference in terms of radiographic outliers was noted between navigation and robotic assistance.

Sections du résumé

BACKGROUND BACKGROUND
Robotic-assisted total knee arthroplasty (RTKA) and navigated total knee arthroplasty (NTKA) have shown improved knee alignment and reduced radiographic outliers. Recent studies have proven that conventional mechanical alignment may not be the optimal goal for every patient. The aim of this study was to compare the accuracy of the planned implant positioning of a novel image-less robotic technique with an established navigated technique (NTKA).
METHOD METHODS
The study is a retrospective analysis of prospectively collected data that compared the implant positioning and lower-limb alignment of 86 image-less RTKA with 86 image-less NTKA. Radiographic analysis was performed to evaluate the lower-limb overall alignment, femoral and tibial components positioning in the coronal and sagittal planes. Outliers were evaluated with a cutoff of ± 3°.
RESULTS RESULTS
No difference was noted between the two groups for radiographic outliers within ± 3° from neutral (p = 0.098). The mean hip-knee-ankle angle deviation from target was 1.3° in the RTKA group compared to 1.9° in the NTKA (p < 0.001). Femoral sagittal deviation (femoral component flexion) was smaller in the RTKA group (0.9° vs 1.9°; p < 0.001). Similarly, tibial coronal deviation (0.8° vs 1.5°; p < 0.001) and tibial sagittal deviation (tibial slope) were smaller in the RTKA group compared to the NTKA group (0.9° vs 1.7°; p < 0.001).
CONCLUSIONS CONCLUSIONS
The RTKA group reported a substantial and significant reduced error from the planned target angles for both tibial and femoral components. No difference in terms of radiographic outliers was noted between navigation and robotic assistance.

Identifiants

DOI: 10.1007/s00402-023-05062-y PMID: 37755480
pubmed: 37755480
doi: 10.1007/s00402-023-05062-y
pii: 10.1007/s00402-023-05062-y
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Auteurs

Fabio Mancino (F)

Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy.
Department of Orthopaedics, The Orthopaedic Research Foundation of Western Australia (ORFWA), Fiona Stanley Hospital, Perth, WA, Australia.

Stefano Marco Paolo Rossi (SMP)

Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy. rossi.smp@gmail.com.
ORCID: 0000-0003-4395-8457

Rudy Sangaletti (R)

Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy.
Università degli Studi di Pavia, Pavia, Italy.

Matteo Caredda (M)

Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy.
Università Cattolica del Sacro Cuore, Rome, Italy.

Flavio Terragnoli (F)

U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy.

Francesco Benazzo (F)

Sezione di Chirurgia Protesica ad Indirizzo Robotico, Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia, Fondazione Poliambulanza Via Bissolati 57, 25124, Brescia, Italy.
IUSS Istituto Universitario Di Studi Superiori, Pavia, Italy.

Classifications MeSH