Joint line is restored in robotic-arm-assisted total knee arthroplasty performed with a tibia-based functional alignment

Zambianchi, Francesco; Bazzan, Gabriele; Marcovigi, Andrea; Pavesi, Marco; Illuminati, Andrea; Catani, Fabio

doi:10.1007/s00402-021-04039-z

Cited by 30 publications

(26 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The same medial mid‐vastus approach was used, and component positioning in the coronal and sagittal planes was performed on a case‐by‐case basis. Intraoperatively, following bone registration, the kinematic data were assessed to make fine adjustments to the preoperative plan prior to bone preparation to achieve a balanced knee with restricted component alignment (within 3° of varus/valgus and 7° of flexion/extension) [36]. The final plan was recorded and later analyzed against postoperative measurements (Fig.…”

Section: Methodsmentioning

confidence: 99%

Functional alignment with robotic‑arm assisted total knee arthroplasty demonstrated better patient-reported outcomes than mechanical alignment with manual total knee arthroplasty

Choi

Kim

Yang

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Given the improved accuracy of robot-assisted surgery, robotic-arm assisted functionally aligned total knee arthroplasty (RFA-TKA) aims to preserve the native pre-arthritic knee biomechanics, to achieve balanced lexion-extension gaps. The purpose of this study was to compare the accuracy of the implant position and short-term clinical outcomes of patients who underwent RFA-TKA vs. mechanically aligned total knee arthroplasty with manual technique (MA-TKA). Methods A prospectively collected database was reviewed retrospectively for patients who underwent primary TKA. Sixty patients who underwent RFA-TKA between February 2020 and July 2020 were included in the RFA-TKA group. Sixty patients who underwent MA-TKA were included via 1:1 matching for age, sex, and body mass index based on the RFA-TKA group. For radiological evaluation, knee X-rays were used to assess the functional knee phenotype and implant position accuracy by measuring the coronal and sagittal alignment, and these measurements were compared between the two groups. Patient demographic characteristics and patient-reported outcomes including Knee Society scores, Western Ontario and McMaster Universities Arthritis Index, and forgotten joint score-12 were compared between the groups. Results Statistically signiicant diferences were observed in postoperative 2-year clinical outcomes in favor of RFA-TKA group which showed greater accuracy in the tibial component sagittal alignment than MA-TKA (1.0 ± 2.3 vs. 0.7 ± 1.6, respectively; P < 0.001). However, outliers in the component positions were more common in the MA-TKA group, which was statistically signiicant for the femoral coronal and tibial sagittal alignments (P = 0.017 and 0.015, respectively). Conclusions Functional alignment in TKA could be accurately obtained with the assistance of a robotic arm, and the results showed greater 2 year postoperative patient-reported outcome and satisfaction than mechanically aligned TKA using manual instruments. Level of evidence III.

show abstract

Section: Methodsmentioning

confidence: 99%

Functional alignment with robotic‑arm assisted total knee arthroplasty demonstrated better patient-reported outcomes than mechanical alignment with manual total knee arthroplasty

Choi

Kim

Yang

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…74 In contrast, a rKA starting point with FA is more likely to reduce lengthening of lateral joint line, maintain medial stability of the MCL to support any medial pivoting, and restore native JLO. 84…”

Section: Individualized Alignment Approaches In Tkamentioning

confidence: 99%

The language of knee alignment

MacDessi

Oussedik

Abdel

et al. 2023

The Bone & Joint Journal

View full text Add to dashboard Cite

Orthopaedic surgeons are currently faced with an overwhelming number of choices surrounding total knee arthroplasty (TKA), not only with the latest technologies and prostheses, but also fundamental decisions on alignment philosophies. From ‘mechanical’ to ‘adjusted mechanical’ to ‘restricted kinematic’ to ‘unrestricted kinematic’ — and how constitutional alignment relates to these — there is potential for ambiguity when thinking about and discussing such concepts. This annotation summarizes the various alignment strategies currently employed in TKA. It provides a clear framework and consistent language that will assist surgeons to compare confidently and contrast the concepts, while also discussing the latest opinions about alignment in TKA. Finally, it provides suggestions for applying consistent nomenclature to future research, especially as we explore the implications of 3D alignment patterns on patient outcomes. Cite this article: Bone Joint J 2023;105-B(2):102–108.

show abstract

“… 37 A similar concept of technique is reported as tibia-based functional alignment with favourable results. 60 They are different from most KA approaches, where the femoral periarthritis articular surface is firstly restored prior to the tibial cut.…”

Section: Introductionmentioning

confidence: 99%

Current concept of kinematic alignment total knee arthroplasty and its derivatives

et al. 2022

View full text Add to dashboard Cite

The kinematic alignment (KA) approach to total knee arthroplasty (TKA) has recently increased in popularity. Accordingly, a number of derivatives have arisen and have caused confusion. Clarification is therefore needed for a better understanding of KA-TKA. Calipered (or true, pure) KA is performed by cutting the bone parallel to the articular surface, compensating for cartilage wear. In soft-tissue respecting KA , the tibial cutting surface is decided parallel to the femoral cutting surface (or trial component) with in-line traction. These approaches are categorized as unrestricted KA because there is no consideration of leg alignment or component orientation. Restricted KA is an approach where the periarthritic joint surface is replicated within a safe range, due to concerns about extreme alignments that have been considered ‘alignment outliers’ in the neutral mechanical alignment approach. More recently, functional alignment and inverse kinematic alignment have been advocated, where bone cuts are made following intraoperative planning, using intraoperative measurements acquired with computer assistance to fulfill good coordination of soft-tissue balance and alignment. The KA-TKA approach aims to restore the patients’ own harmony of three knee elements (morphology, soft-tissue balance, and alignment) and eventually the patients’ own kinematics. The respective approaches start from different points corresponding to one of the elements, yet each aim for the same goal, although the existing implants and techniques have not yet perfectly fulfilled that goal.

show abstract

Joint line is restored in robotic-arm-assisted total knee arthroplasty performed with a tibia-based functional alignment

Cited by 30 publications

References 30 publications

Functional alignment with robotic‑arm assisted total knee arthroplasty demonstrated better patient-reported outcomes than mechanical alignment with manual total knee arthroplasty

Functional alignment with robotic‑arm assisted total knee arthroplasty demonstrated better patient-reported outcomes than mechanical alignment with manual total knee arthroplasty

The language of knee alignment

Current concept of kinematic alignment total knee arthroplasty and its derivatives

Contact Info

Product

Resources

About