Optimization of sagittal and coronal planes with robotic-assisted unicompartmental knee arthroplasty

Gaudiani, Michael A.; Nwachukwu, Benedict U.; Baviskar, Jayesh V.; Sharma, Mrinal; Ranawat, Anil S.

doi:10.1016/j.knee.2017.05.002

Cited by 37 publications

(30 citation statements)

References 36 publications

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“…41 Another study, analyzing a single surgeon's robotic-arm assisted UKA alignment of 56 right and 38 left knees, also found that no differences attributable to laterality as significant pre-to postoperative mechanical axis alignment correction could be achieved on both sides using the robotic-assisted device (5 AE 3 degrees of varus vs. 3 AE 2 degrees of varus; p < 0.0001). 42 In a large retrospective study on 6,070 left and right knees with varying degrees of coronal alignment, it was found that 4,236 (70%) patients were corrected to normal alignment within 1 SD from the mean (mean: 4.8 AE 2.5 degrees; range: 2.4-7.2 degrees of valgus), with no distinct differences mentioned regarding joint laterality and outcomes. 43 The successful outcomes of these studies evaluating both the left and right knees further highlight that hand-dominance and joint laterality play a minimal role in influencing surgical outcomes.…”

Section: Discussionmentioning

confidence: 97%

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques

et al. 2018

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This study determined if robotic-arm assisted total knee arthroplasty (RATKA) allows for more accurate and precise bone cuts and component position to plan compared with manual total knee arthroplasty (MTKA). Specifically, we assessed the following: (1) final bone cuts, (2) final component position, and (3) a potential learning curve for RATKA. On six cadaver specimens (12 knees), a MTKA and RATKA were performed on the left and right knees, respectively. Bone-cut and final-component positioning errors relative to preoperative plans were compared. Median errors and standard deviations (SDs) in the sagittal, coronal, and axial planes were compared. Median values of the absolute deviation from plan defined the accuracy to plan. SDs described the precision to plan. RATKA bone cuts were as or more accurate to plan based on nominal median values in 11 out of 12 measurements. RATKA bone cuts were more precise to plan in 8 out of 12 measurements ( ≤ 0.05). RATKA final component positions were as or more accurate to plan based on median values in five out of five measurements. RATKA final component positions were more precise to plan in four out of five measurements ( ≤ 0.05). Stacked error results from all cuts and implant positions for each specimen in procedural order showed that RATKA error was less than MTKA error. Although this study analyzed a small number of cadaver specimens, there were clear differences that separated these two groups. When compared with MTKA, RATKA demonstrated more accurate and precise bone cuts and implant positioning to plan.

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Section: Discussionmentioning

confidence: 97%

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques

et al. 2018

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“…By scanning the titles and abstracts, 17 articles that met the inclusion criteria were reviewed for full‐text screening. After full texts were assessed for eligibility, some articles were rejected because they performed studies on sawbones or cadaver knees, 10,21,22 reported with insufficient data, 23–25 and the data have been reported elsewhere 26 . Finally, a total number of 10 eligible articles were described.…”

Section: Resultsmentioning

confidence: 99%

“…By providing real‐time quantification of ligament balancing during different flexion extension cycles, Plate et al found the robotic‐assisted system could accurately reproduce intraoperatively planned ligamentous balance 36 . However, not all studies favoured robotic‐assisted system 25,32 . Hansen et al reported no significant difference in the tibial slope between the two groups 32 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of robotic‐assisted versus conventional unicompartmental knee arthroplasty for the treatment of single compartment knee osteoarthritis: A meta‐analysis

Zhang

et al. 2020

Robotics Computer Surgery

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Background The robotic‐assisted unicompartmental knee arthroplasty (UKA) is proposed to improve the accuracy of component positioning. Methods We conducted a literature search in Medline, Embase, Web of Science and the Cochrane Library until April 2020. Results Our meta‐analysis included 10 articles, involving 1231 knees. Our meta‐analysis demonstrated that the robotic group had significantly better results in outliers of limb alignment (p < 0.001) and outliers of tibial alignment (p < 0.001). No statistical differences were found in the American Knee Society Score (p = 0.63), range of motion (p = 0.93), pain (p = 0.27), rate of revisions (p = 0.73) and rate of complications (p = 0.67). Conclusions Robotic‐assisted UKA has better component position accuracy compared with conventional UKA. But there was no significant difference in clinical results. In order to further evaluate the utility of robotic‐assisted UKA, long‐term follow‐up randomized controlled trials (RCTs) are needed, as well as studies to evaluate the correlation between postoperative alignment and long‐term clinical results.

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“…These outcomes will be used to calculate root mean square errors values for accuracy of femoral and tibial component positioning within the coronal, sagittal, and axial planes as described by Bell et al [ 4 ]. The posterior condylar offset ratio (PCOR) and posterior tibial slope will be assessed using the methods described by Gaudiani et al and Johal et al respectively [ 13 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

Robotic-arm assisted medial unicondylar knee arthroplasty versus jig-based unicompartmental knee arthroplasty with navigation control: study protocol for a prospective randomised controlled trial

Kayani

Konan

Tahmassebi

et al. 2020

Trials

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Background There remains a paucity of clinical studies assessing how any differences in accuracy of implant positioning between robotic-arm assisted unicompartmental knee arthroplasty (RO UKA) and conventional jig-based unicompartmental knee arthroplasty (CO UKA) translate to patient satisfaction, functional outcomes, and implant survivorship. The objectives of this study are to compare accuracy of implant positioning, limb alignment, patient satisfaction, functional outcomes, implant survivorship, cost-effectiveness, and complications in CO UKA versus RO UKA. Computer navigation will be used to assess intraoperative knee kinematics in all patients undergoing CO UKA. Methods and analysis This prospective randomised controlled trial will include 140 patients with symptomatic medial compartment knee arthritis undergoing primary UKA. Following informed consent, patients will be randomised to CO UKA (control group) or RO UKA (investigation group) at a ratio of 1:1 using an online random number generator. The primary objective of this study is to compare accuracy of implant positioning in CO UKA versus RO UKA. The secondary objectives are to compare the following outcomes between the two treatment groups: limb alignment, surgical efficiency, postoperative functional rehabilitation, functional outcomes, quality of life, range of motion, resource use, cost effectivness, and complications. Observers will review patients at regular intervals for 2 years after surgery to record predefined study outcomes pertaining to these objectives. Ethical approval was obtained from the London-Bloomsbury Research Ethics Committee, UK. The study is sponsored by University College London, UK. Discussion This study compares a comprehensive and robust range of clinical, functional, and radiological outcomes in CO UKA versus RO UKA. The findings of this study will provide an improved understanding of the differences in CO UKA versus RO UKA with respect to accuracy of implant positioning, patient satisfaction, functional outcomes, implant survivorship, cost-effectiveness, and complications. Trial registration ClinicalTrials.gov NCT04095637 . Registered on 19 September 2019.

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Optimization of sagittal and coronal planes with robotic-assisted unicompartmental knee arthroplasty

Cited by 37 publications

References 36 publications

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques

Robotic-Arm Assisted Total Knee Arthroplasty Demonstrated Greater Accuracy and Precision to Plan Compared with Manual Techniques

Comparison of robotic‐assisted versus conventional unicompartmental knee arthroplasty for the treatment of single compartment knee osteoarthritis: A meta‐analysis

Robotic-arm assisted medial unicondylar knee arthroplasty versus jig-based unicompartmental knee arthroplasty with navigation control: study protocol for a prospective randomised controlled trial

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