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

Abstract

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.

Accuracy of a New Robotically Assisted Technique for Total Knee Arthroplasty: A Cadaveric Study

“…A variety of femoral and tibial angular measures generally revealed significantly reduced bone cutting errors for the robotic-assisted group [14]. Unfortunately, no measures of planned vs achieved resection thicknesses were provided in that paper [14]. Study design and reporting differences make direct comparisons to the current work difficult, however, bone cut error variances in that report appear generally consistent with our current findings [14].…”

“…Furthermore, the number of knees used was not sufficient to reach any level of significance [13]. Another publication reported a cadaveric study comparing TKA implanted on cadavers with either a robotic-arm technique or a conventional instrument system [14]. In that comparative study, a single surgeon performed robotic-assisted or conventional instrument TKA on one leg each of 6 cadavers, for a total of 6 of each type [14].…”

“…Another publication reported a cadaveric study comparing TKA implanted on cadavers with either a robotic-arm technique or a conventional instrument system [14]. In that comparative study, a single surgeon performed robotic-assisted or conventional instrument TKA on one leg each of 6 cadavers, for a total of 6 of each type [14]. A variety of femoral and tibial angular measures generally revealed significantly reduced bone cutting errors for the robotic-assisted group [14].…”

“…In that comparative study, a single surgeon performed robotic-assisted or conventional instrument TKA on one leg each of 6 cadavers, for a total of 6 of each type [14]. A variety of femoral and tibial angular measures generally revealed significantly reduced bone cutting errors for the robotic-assisted group [14]. Unfortunately, no measures of planned vs achieved resection thicknesses were provided in that paper [14].…”

Robotic Arm Assisted Total Knee Arthroplasty: Addressing 1-12 Degrees Valgus Knees

“…To reduce inadvertent soft tissue damage in a valgus case, it has been suggested that precise bone resections could be applied while maintaining the integrity of the soft tissue envelope. Robotic assisted (RA) technology has been shown to have three dimensional (3D) cut accuracy which could assist with addressing these complex cases [4]. The purpose of this work was to determine the number of soft tissue releases and component orientation of valgus cases performed with RA total knee arthroplasty (TKA).…”