Two‐ and three‐dimensional measurements following robotic‐assisted total knee arthroplasty

Hasegawa, Masahiro; Tone, Shine; Naito, Yohei; Sudo, Akihiro

doi:10.1002/rcs.2455

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…The intra-and interobserver reliability of this measurement have been previously studied. 11 The intra-observer reliability for the femoral coronal, femoral sagittal, tibial coronal, and tibial sagittal alignments were 0.95, 0.94, 0.83, and 0.95, respectively. The interobserver reliability for the femoral coronal, femoral sagittal, tibial coronal, and tibial sagittal alignments were 0.85, 0.78, 0.76, and 0.80, respectively.…”

Section: Methodsmentioning

confidence: 86%

“…3D measurements with CT are more reliable for investigating component alignment after TKA. 11,34,35 Fifth, the robot might not make a mistake; however, errors could occur during implantation.…”

Section: Discussionmentioning

confidence: 99%

“…The interobserver reliability for the femoral coronal, femoral sagittal, tibial coronal, and tibial sagittal alignments were 0.85, 0.78, 0.76, and 0.80, respectively. 11 Outliers for HKA and component alignment were defined as >3°deviation from the planned alignment.…”

Section: Methodsmentioning

confidence: 99%

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Comparing an imageless hand‐held robotic‐assisted system versus conventional technique for component positioning and early clinical outcomes in total knee arthroplasty

Hasegawa,

Hattori,

Naito

et al. 2023

Robotics Computer Surgery

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BackgroundThis study aimed to examine the component positioning and early clinical outcomes in total knee arthroplasty (TKA) using an imageless hand‐held robotic‐assisted system compared with those without robotics.MethodsComponent positioning, hip‐knee‐ankle angle (HKA), and clinical outcome 1‐year postoperatively were compared between 40 patients who underwent TKA with Navio (robot group) and 40 control patients who underwent TKA with a jig‐based technique (manual group). The clinical outcomes evaluated were range of motion and the 2011 Knee Society Score.ResultsImplantation errors in the coronal and sagittal alignments were significantly fewer in the robotic group than in the manual group. All knees in the robotic group achieved component positions within 3°. However, the HKA and clinical outcomes did not differ between the groups.ConclusionAlthough the accuracy of implantation in the robotic group was superior to that in the manual group, the clinical outcomes were similar.

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Section: Methodsmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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Comparing an imageless hand‐held robotic‐assisted system versus conventional technique for component positioning and early clinical outcomes in total knee arthroplasty

Hasegawa,

Hattori,

Naito

et al. 2023

Robotics Computer Surgery

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“…These studies reported comparable or decreased number of outliers with RATKA. However, in those studies, the accuracy and measurements were performed on standardized radiographs, which introduces a low reproducibility with known inaccuracies when compared with CT‐based measurements [5, 8]. To the best of our knowledge, the present trial is the first study that used CT‐based measurement techniques to determine implant placement accuracy for TKA with the use of 3D‐to‐3D surface registration between the perioperative planned and postoperative achieved implant placement in a prospective RCT comparing image‐free RATKA with CTKA.…”

Section: Discussionmentioning

confidence: 99%

Improved accuracy of implant placement with an imageless handheld robotic system compared to conventional instrumentation in patients undergoing total knee arthroplasty: a prospective randomized controlled trial using CT‐based assessment of radiological outcomes

Bollars,

Janssen,

De Weerdt

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose Image-free handheld robotic-assisted total knee arthroplasty (RATKA) has shown to achieve desired limb alignment compared to conventional jig-based instrumented total knee arthroplasty (CTKA). The aim of this prospective randomized controlled trial (RCT) was to evaluate the accuracy of a semi-autonomous imageless handheld RATKA compared to CTKA in order to achieve the perioperative planned target alignment of the knee postoperatively. Methods Fifty-two patients with knee osteoarthritis were randomized in 1:1 ratio to undergo unilateral CTKA or an imageless handheld RATKA. A full-length lower limb CT-scan was obtained pre-and 6-week postoperative. The primary outcomes were radiologic measurements of achieved target hip-knee-ankle axis (HKA-axis) and implant component position including varus and external rotation and flexion of the femur component, and posterior tibial slope. The proportion of outliers in above radiographic outcomes, defined as > 3° deviation in postoperative CT measurements as compared to perioperative planned target, were also noted. Knee phenotypes were compared with use of the Coronal Plane Alignment of the Knee (CPAK) classification. Results Baseline conditions were comparable between both groups. The overall proportion and percentage of outliers (n = 38, 24.4% vs n = 9, 5.8%) was statistically significant (p < 0.001) in favor of RATKA. The achieved varus-valgus of the femoral component (varus 1.3° ± 1.7° vs valgus − 0.1° ± 1.9°, p < 0.05) with statistically significant less outliers (0% vs 88.5%, p < 0.01), the achieved HKA-axis (varus 0.4° ± 2.1° vs valgus − 1.2° ± 2.1°, p < 0.05) and the posterior tibial slope (1.4° ± 1.1° vs 3.2° ± 1.8°, p < 0.05) were more accurate with RATKA. The most common postoperative CPAK categories were type II (50% CTKA vs 61.5% RATKA), type I (3.8% CTKA vs 23.1% RATKA) and type V (26.9% CTKA vs 15.4% RATKA). CPAK classification III was only found in CTKA (19.2%). Type VI, VII, VIII, and IX were rare in both populations. Conclusions The present trial demonstrates that an imageless handheld RATKA system can be used to accurately perioperatively plan the desired individual component implant positions with less alignment outliers whilst aiming for a constitutional alignment. Level of evidence I.

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“…The ROSA ® Knee System is a semiactive robotic system that controls the placement of cutting jigs and allows the surgeon to use a preferred saw blade for bone resections and dynamic ligament balancing. Resection depth and cut angle accuracies have been reported as less than 0.7 mm and within 1° ( 23 , 27 ), respectively, and several studies provide evidence that the ROSA Knee System can improve implant positioning ( 27 ), hip-knee-ankle angle ( 23 , 28 , 29 ), and patient reported outcome scores ( 30 ) compared to conventional TKA.…”

Section: Introductionmentioning

confidence: 99%

Personalized alignment™ for total knee arthroplasty using the ROSA® Knee and Persona® knee systems: Surgical technique

2023

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Total knee arthroplasty (TKA) procedures are expected to increase up to 565% in the United States over the next 3 decades. TKAs were traditionally performed with neutral mechanical alignments that provided equal medial and lateral gaps in extension and flexion to reduce implant wear but were less successful at restoring native knee function and associated with high patient dissatisfaction. Kinematic alignment (KA) restores native anatomy and minimizes soft tissue release; however, KAs that recreate severe deformities and/or biomechanically inferior alignments result in significant increases in implant stress and risk of aseptic loosening. Restricted kinematic alignment (rKA) recreates pre-arthritic anatomy within a range of acceptable alignment boundaries, and improved patient clinical scores and faster recoveries have been reported with rKA techniques. Personalized Alignment™ is an evolution of rKA that relies heavily upon robotic assistance to reliably recreate patient anatomy, native soft tissue laxity, and accurate component placement to improve patients' clinical outcomes. The purpose of this surgical technique report is to describe the Personalized Alignment TKA method using the ROSA® Knee System and Persona® The Personalized Knee® implants. Herein we provide specific procedures for pre-operative planning, anatomical landmarking and evaluation, intra-operative planning and adjustment of resections and cuts, cut validation and soft tissue evaluation with robotic-assisted personalized TKA.

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Two‐ and three‐dimensional measurements following robotic‐assisted total knee arthroplasty

Cited by 9 publications

References 32 publications

Comparing an imageless hand‐held robotic‐assisted system versus conventional technique for component positioning and early clinical outcomes in total knee arthroplasty

Comparing an imageless hand‐held robotic‐assisted system versus conventional technique for component positioning and early clinical outcomes in total knee arthroplasty

Improved accuracy of implant placement with an imageless handheld robotic system compared to conventional instrumentation in patients undergoing total knee arthroplasty: a prospective randomized controlled trial using CT‐based assessment of radiological outcomes

Personalized alignment™ for total knee arthroplasty using the ROSA® Knee and Persona® knee systems: Surgical technique

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