The History of the Development of Robotics in Surgery and Orthopedics (Literature Review)

Лычагин, А.В.; Gritsyuk, A.A.; Rukin, Ya. A.; Elizarov, Mikhail

doi:10.17238/issn2226-2016.2020.1.13-19

Cited by 4 publications

(1 citation statement)

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“…With manual TKA technique, up to 40% of the implant position is affected, which affects the function and shortens the service life of the implant [9], [10]. One of the ways to solve the problem is the use of computer navigation, which makes it possible to improve the results of alignment of the axes and the position of the implant, but the number of errors remains quite large [11], [12].…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted Knee Arthroplasty: Randomized Clinical Trial

Лычагин

Elizarov

Gritsyuk

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Osteoarthritis of the knee joint leads to a decrease in the volume of movements, a violation of the sliding of articular surfaces, and a change in the axis of the limb under load, which affects the biomechanics of walking. AIM: This study aims to compare the results of robot-assisted total knee arthroplasty (TKA) and manual techniques, their influence on the biomechanical and podometric parameters of the patient’s walk. METHODS: A prospective randomized study of 68 patients was carried out in the period from 2020 to 2021. Our follow-up period was 1 year. All patients were performed arthroplasty of one knee joint. The main Group “A” included 33 patients TKA with the use of an active robotic setting “TSolution-One” (“THINK Surgical, Inc.” [Fremont, California, USA]); the comparison Group “B” consisted of 35 patients with manual technic of TKA. We studied pain syndrome on the visual analog scale, functional state on the Oxford Knee Score (OKS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC), the volume of ROM movements, and the deviation of the mechanical axis by teleroentgenography of the lower limb. Objective analysis of limb function was performed on the «Alter-G» and the «C-mill». RESULTS: Post-operative pain syndrome on the 1st day after surgery in Group A is stronger by 7.9%, but by the 5th day after surgery in Group A, the pain syndrome is lower by 14.3%. ROM in Group A is better by 16% by 3 months after surgery, after 1 year by 10%. The positioning accuracy of the implant in Group A is 30% better. There are no statistically significant differences in the OKS and WOMAC scales between the groups. The results of restoring normal step in Group A are 13.5% better than in Group B. CONCLUSIONS: Robot-assisted TKA gives more accurate alignment of the mechanical axis, which improves the biomechanics of walking.

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Section: Introductionmentioning

confidence: 99%

Robot-assisted Knee Arthroplasty: Randomized Clinical Trial

Лычагин

Elizarov

Gritsyuk

et al. 2022

Open Access Maced J Med Sci

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Clinical evaluation and accuracy of mechanical axis alignment in robotic total knee arthroplasty

Lychagin,

Gritsyuk,

Rukin

et al. 2023

jour

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The first experience in robotic total knee arthroplasty (RoTKA) has been obtained resulting in the questions about clinical efficiency and accuracy of lower limb alignment.Objective To clarify clinical evaluation and accuracy of alignment of the mechanical axis of the lower limb in RoTKA.Materials and methods Twenty-nine patients with osteoarthritis of the knee of Kellgren-Lawrence stage 3-4 underwent RoTKA. The knee joint was assessed with VAS, WOMAC, FJS-12; the range of motion was measured. The changes in the axis of the lower limb were evaluated on the full limb length radiographs.Results Pain before the surgery according to VAS was 5.8 ± 1.5 points, on the first day after the surgery it was 8.5 ± 1.4, on day 3 – 5.9 ± 1.2, on day 12 – 2.9 ± 1.1. The range of motion on the first day after the surgery was 99.5° ± 1.4°, three months later – 115.1° ± 1.1°, six months later – 125.6 ± 1.5°, one year later– 127.5 ± 1.6°. The WOMAC score before the surgery was 32.7 ± 3.3, after the surgery 25.1 ± 2.1, three months later 7.3 ± 1.3, six months later 2.8 ± 0.2, and after one year – 1.3 ± 0.5. The FJS-12 score 3 months after the surgery was 68.2 ± 4.1, after 6 months 80.3 ± 2.9, after one year 94.0 ± 2.1. The analysis of postoperative full length roentgenograms in 72 % of cases (n = 21) did not reveal any deviation of the mechanical axis from the planned one and in 28 % of cases (n = 8) the deviation of the mechanical axis was up to 1° from the planned one.Discussion Neither technical difficulties nor complications inherent to RoTKA were found. According to the results of VAS, WOMAC and FJS‑12 questionnaires, and the assessment of the range of motion, a positive dynamics was observed. According to the results of tele-roentgenograms, there was alignment of the limb axis and the accuracy of the position of the endoprosthesis components.Conclusion The study of this technology has demonstrated safety, accuracy of alignment of the mechanical axis, validity of indications and contraindications, and stable early clinical results.

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Kinematic alignment in robotic total knee arthroplasty

Lychagin,

Gritsyuk,

Kalinsky

et al. 2024

jour

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Introduction There are two main concepts of total knee arthroplasty: mechanical and anatomical alignment of the lower limb axis. Howell et al. (2013) proposed the concept of kinematic alignment, the main idea of which is to preserve the level of the joint line and the axis of the lower limb that patients had before the onset of osteoarthritis. Initially, kinematic alignment was proposed to be performed with individual guides based on the results of CT/MRI scans but they took a long time to manufacture, were difficult to install, broke down, and were quite expensive. Introduction of robotic orthopaedic systems into clinical practice enabled to plan and perform bone resection with high accuracy, to install the components of the implant system according to the necessary concept thus providing new opportunities for the application of kinematic alignment, which was the purpose of our study.Purpose To study the possibilities of a robotic surgical system in performing restricted kinematic alignment in total knee arthroplasty (TKA).Materials and methods A prospective single-center study was conducted in 47 patients (12 men and 35 women) with knee osteoarthritis in Kellgren – Lawrence grades 3–4, an average age of (65.87 ± 7.4) years, an average BMI of (31.3 ± 4.7) kd/m2 , median HKA angle of 175°, median LDFA of 87°, median MPTA of 87°. The patients underwent robotic total knee arthroplasty (RoTKA) with the method of restricted kinematic alignment.Results On the control whole-leg radiographs, the average HKA angle after surgery was (176 ± 1.5)°. In 42.6 % of cases, the deviation from the plan was within ± 1°, the deviation ± 2° in 44.7 % of cases, and in the remaining 12.7 % of cases the deviation was negative.Discussion In the literature, we did not find the results of radiographic evaluation of the HKA angle in the coronal view before and after robotic total knee arthroplasty and their comparison with the results of preoperative planning using the kinematic alignment method of the limb axis. The results we obtained show high accuracy of the implementation of the preoperative plan.Conclusion A personalized approach to TKA with application of an autonomous robotic system effectively provides kinematic alignment of the axis of the lower limb with an accuracy of up to 2° in 87.3 % of patients.

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The History of the Development of Robotics in Surgery and Orthopedics (Literature Review)

Cited by 4 publications

References 0 publications

Robot-assisted Knee Arthroplasty: Randomized Clinical Trial

Robot-assisted Knee Arthroplasty: Randomized Clinical Trial

Clinical evaluation and accuracy of mechanical axis alignment in robotic total knee arthroplasty

Kinematic alignment in robotic total knee arthroplasty

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