Difficult Cases in Robotic Arm-Assisted Total Knee Arthroplasty: A Case Series

Abstract

Sagittal deformity of the knee is commonly corrected to neutral biomechanical axis (±3 degrees) during total knee arthroplasty (TKA), which is a widely accepted goal. Recent advances in surgical technology have made it possible to accurately plan and fulfill these goals. One of these is robotic-assisted TKA, which has been noted to help increase accuracy and precision of restoring a neutral mechanical axis. While there are data confirming the ability of robotic devices to better correct knee alignment than the manual technique, there is a lack of data concerning the use of the robotic devices in more complex cases, such as those in patients with severe varus or valgus deformity, as well as in flexion contractures. Therefore, the purpose of this case study is to present three cases in which the robotic-assisted TKA device was used to correct a severe varus and severe valgus deformities. Based on this case series, it should be noted that the robotic device can also help correct severe varus/valgus deformities and flexion contractures.

Does the Robotic Arm and Preoperative CT Planning Help with 3D Intraoperative Total Knee Arthroplasty Planning?

“…RA-TKA is a surgical technique that has been found to have great patient satisfaction outcomes, optimal implant positioning, and soft tissue protection. [1][2][3][4] This study reported on the intraoperative surgical advantages of the RA-TKA system. The device was found to substantially help the surgeon achieve greater reduction in flexion and extension gaps, resulting in a more balanced knee intraoperatively.…”

“…Robotic arm-assisted total knee arthroplasty (RA-TKA) is a surgical technique with several potential surgical and clinical advantages compared with manual technique TKA. [1][2][3][4] Recent reports have shown soft-tissue protection to be one of many potential clinical advantages of RA-TKA. 1 For example, RA-TKA creates a bony island on the tibial plateau, protecting the posterior cruciate ligament.…”

“…[1][2][3][4] Recent reports have shown soft-tissue protection to be one of many potential clinical advantages of RA-TKA. 1 For example, RA-TKA creates a bony island on the tibial plateau, protecting the posterior cruciate ligament. 2 RA-TKA has also been shown to produce more precise knee coronal alignment and implant placement.…”

“…3 One study of 330 RA-TKAs found that all valgus knees, regardless of deformity severity, were corrected to neutral. The same study reported that all 132 knees with varus deformity of less than 7 degrees (mean, 4 degrees, range, [1][2][3][4][5][6] were also corrected to neutral. 3 Another advantage of the RA-TKA is the short learning curve to achieve the above clinical results.…”

Robotic Assisted Total Knee Arthroplasty in Presence of Extra-Articular Deformity

“…In the presence of these extra-articular deformities, standard operative techniques and instruments may not be reliable. Robotic-arm assisted technology was developed to help achieve a well-aligned and balanced knee in a variety of clinical scenarios [1][2][3][4] . Although prior case series have reported on the use of robotic-arm assisted devices for cases with severe angular deformity, there is a lack of data concerning the use of the robotic device for patients with other potentially complex surgical factors.…”