How reproducible are clinical measurements in robotic knee surgery?

Matassi, Fabrizio; Bori, Edoardo; Giabbani, Niccolò; Civinini, Roberto; Innocenti, Bernardo

doi:10.1186/s40634-023-00582-3

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…The absolute values of the gaps, therefore, could vary from surgeon to surgeon. Matassi et al in their study examining the reproducibility of measurements of Hip‐Knee‐Ankle angle and internal–external rotation, using the MAKO robot, showed excellent intraobserver reliability [15].…”

Section: Discussionmentioning

confidence: 99%

Functionally aligned total knee arthroplasty: A lateral flexion laxity up to 6 mm is safe!

Nixon,

Tadros,

Moreno‐Suarez

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeLoose flexion gaps are associated with poor functional outcomes and instability in total knee arthroplasty (TKA). The effect of a trapezoidal flexion gap in a functionally aligned TKA remains unknown. The aim of this study was to investigate the effect of a larger lateral flexion gap in a robotic‐assisted (RA), functionally aligned (FA) and cruciate‐retaining (CR) TKA on clinical outcomes.MethodsData from 527 TKA in 478 patients from 2018 to 2020 were collected. All patients underwent an RA (MAKO, Stryker), FA and CR TKA. Gap measurements were collected intraoperatively. Patient‐reported outcome measures (PROMs), pain Visual analogue score (VAS) and range of motion were collected postoperatively. Patients were also asked about the ease of stair ascent and descent and kneeling on a 5‐point scale. The minimum follow‐up was 2 years. Patients were stratified into three groups based on lateral flexion laxity.ResultsAt 2 years postoperatively, the group with a looser gap (3–6 mm) had higher mean PROMs when compared with the group with a gap of 2–3 mm. There were no differences detected in any other outcomes at 2 years. A total of 70.9% of patients in the group with a 3–6 mm gap reported being able to walk down a flight of stairs 'easily', compared with 56.7% in the 2–3 mm group and 54% in the <2 mm group (p = 0.04).ConclusionThe study shows that a loose lateral flexion gap in functionally aligned CR TKA does not adversely affect outcomes in the short term.Level of EvidenceLevel III, retrospective cohort study.

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Section: Discussionmentioning

confidence: 99%

Functionally aligned total knee arthroplasty: A lateral flexion laxity up to 6 mm is safe!

Nixon,

Tadros,

Moreno‐Suarez

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Following publication of the original article [ 1 ], the authors’ given name and family name were switched.…”

mentioning

confidence: 99%

“…The correct authors’ name are shown in the authorgroup section of this article and the original article [ 1 ] has been corrected.…”

mentioning

confidence: 99%

Correction: How reproducible are clinical measurements in robotic knee surgery?

et al. 2023

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Effect of tibia‐first, restricted functional alignment technique on gap width changes, and component positioning in robotic arm‐assisted total knee arthroplasty

Yang,

Cheon,

Kang

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThis study aims to quantitatively assess the predictability of post‐resection gap dimensions and the attainment of balanced gaps using robotic arm‐assisted total knee arthroplasty (TKA).MethodsThis retrospective cohort study included 100 consecutive patients who underwent robotic arm‐assisted TKA for knee osteoarthritis using a restricted functional alignment (FA) technique. Tibial cuts were performed based on preoperative tibial anatomy within predefined boundaries, followed by femoral component adjustments according to tensioned soft tissues to optimise gap balance. The primary outcome was the proportion of balanced gaps, defined as differential laxities of ≤2 mm, across extension, flexion, lateral, and medial gap measurements. Ligament balancing in lateral and medial compartments was assessed using a robotic system at 10° and 90° flexion to evaluate if restricted FA facilitated a balanced knee. Secondary outcomes included implant alignment, resection depth, and patient‐reported outcome measures (PROMs).ResultsSignificant increases in both lateral and medial gaps at 10° and 90° flexion were observed following tibial and femoral bone resections (p < 0.001). At extension, average gap changes were 0.9 mm (lateral) and 1.6 mm (medial) after tibial cuts, and 0.5 mm (lateral) and 1.2 mm (medial) after femoral cuts. At 90° flexion, changes were 0.3 mm (lateral) and 1.7 mm (medial) following tibial cuts, and 1.0 mm (lateral) and 1.4 mm (medial) after femoral cuts. Despite these variations, the tibia‐first, gap‐balancing technique achieved overall balance in 98% of gap measurements. The tibial component was placed at an average of 2.1° varus, while the femoral component was positioned at 0.3° varus and 1.3° external rotation relative to the surgical transepicondylar axis. Significant improvements in PROMs were noted between preoperative and one‐year postoperative evaluations (all p < 0.05).ConclusionsThe tibia‐first, restricted FA technique achieved a well‐balanced knee in 98% of cases, despite inconsistent gap increments observed between initial assessments and post‐resection.Level of EvidenceTherapeutic Level IV.

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How reproducible are clinical measurements in robotic knee surgery?

Cited by 3 publications

References 34 publications

Functionally aligned total knee arthroplasty: A lateral flexion laxity up to 6 mm is safe!

Functionally aligned total knee arthroplasty: A lateral flexion laxity up to 6 mm is safe!

Correction: How reproducible are clinical measurements in robotic knee surgery?

Effect of tibia‐first, restricted functional alignment technique on gap width changes, and component positioning in robotic arm‐assisted total knee arthroplasty

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