Abstract:Introduction: With increasing numbers of knee arthroplasty procedures being performed, revision total knee arthroplasty (TKA) remains a challenge to orthopedic surgeons. The use of robotics in primary joint arthroplasty is also increasing due to better technology and surgeon familiarity. Robotic arms have the ability to execute bone cuts within 1 mm of a preoperative plan, can measure soft tissue gap tension, and can plan femoral and tibial augments and rotation. The use of robotic arm assistance for revision … Show more
“…Considering that there has been some pioneering work in applying the robotic system in revision TJA (22,23,24,25,26,27,28,29,30,31), and robotic-assisted technology may have more extended applications in the future, we performed a scoping review of the literature and narrative synthesis to present the current state-of-the-art.…”
Background: During the past decades, robotic-assisted technology has experienced an incredible advancement in the field of total joint arthroplasty (TJA), which demonstrated promise in improving the accuracy and precision of implantation and alignment in both primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, revision TJA remains a technically challenging procedure with issues of large-scale bone defects and damage to nearby anatomical structures. Thus, surgeons are trying to harness the abilities of robotic-assisted technology for revision TJA surgery.
Methods: PubMed, Embase, Cochrane Library, and Google Scholar were comprehensively searched to identify relevant publications that reported the application of robotic-assisted technology in revision TJA.
Results: Overall, ten studies reported the use of the robotic system in revision TJA, including active (ROBODOC) and semi-active (MAKO and NAVIO) systems. One clinical case reported conversion from hip fusion to THA, and three studies reported revision from primary THA to revision THA. Moreover, four studies reported that robotic-assisted technology is helpful in revising unicompartmental knee arthroplasty (UKA) to TKA, and two case reports converted primary TKA to revision TKA. In this study, we present the latest evolvements, applications, and technical obstacles of robotic-assisted technology in the revision of TJA and the current state-of-the-art.
Conclusion: Current available evidence suggests that robotic-assisted technology may help surgeons to reproducibly perform preoperative plans and accurately achieve operative targets during revision TJA. However, concerns remain regarding preoperative metal artifacts, registration techniques, closed software platforms, further bone loss after implant removal, and whether robotic-assisted surgery will improve implant positioning and long-term survivorship.
“…Considering that there has been some pioneering work in applying the robotic system in revision TJA (22,23,24,25,26,27,28,29,30,31), and robotic-assisted technology may have more extended applications in the future, we performed a scoping review of the literature and narrative synthesis to present the current state-of-the-art.…”
Background: During the past decades, robotic-assisted technology has experienced an incredible advancement in the field of total joint arthroplasty (TJA), which demonstrated promise in improving the accuracy and precision of implantation and alignment in both primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, revision TJA remains a technically challenging procedure with issues of large-scale bone defects and damage to nearby anatomical structures. Thus, surgeons are trying to harness the abilities of robotic-assisted technology for revision TJA surgery.
Methods: PubMed, Embase, Cochrane Library, and Google Scholar were comprehensively searched to identify relevant publications that reported the application of robotic-assisted technology in revision TJA.
Results: Overall, ten studies reported the use of the robotic system in revision TJA, including active (ROBODOC) and semi-active (MAKO and NAVIO) systems. One clinical case reported conversion from hip fusion to THA, and three studies reported revision from primary THA to revision THA. Moreover, four studies reported that robotic-assisted technology is helpful in revising unicompartmental knee arthroplasty (UKA) to TKA, and two case reports converted primary TKA to revision TKA. In this study, we present the latest evolvements, applications, and technical obstacles of robotic-assisted technology in the revision of TJA and the current state-of-the-art.
Conclusion: Current available evidence suggests that robotic-assisted technology may help surgeons to reproducibly perform preoperative plans and accurately achieve operative targets during revision TJA. However, concerns remain regarding preoperative metal artifacts, registration techniques, closed software platforms, further bone loss after implant removal, and whether robotic-assisted surgery will improve implant positioning and long-term survivorship.
“…There are previously published reports of robotic arm–assisted conversion of unicompartmental knee arthroplasty to TKA, including 1 case report [ 5 ] and 1 case series [ 6 ]. Robotic arm–assisted revision of failed primary total knee arthroplasty was first described by Steelman et al [ 7 ], in August 2021 in a patient with aseptic loosening of the tibial component. The technique described by Steelman et al.…”
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confidence: 99%
“… Figure 1 Intraoperative mapping directly off of patient current implants. The implants represent native bone for the preoperative plan and registration process [ 7 ]. Figure 2 AP and lateral postoperative radiographs of right total knee arthroplasty revision utilizing robotic arm assistance.…”
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confidence: 99%
“… Figure 2 AP and lateral postoperative radiographs of right total knee arthroplasty revision utilizing robotic arm assistance. Implants used: Femur – Cemented Stryker Triathlon TS #5 with 15 mm × 50 mm stem, 10-mm medial and lateral posterior augments, and size 1-2 Tritanium cone; Tibia – Cemented Stryker Triathlon universal tibial baseplate size 4 with 12 mm × 50 mm stem, and size A Tritanium cone; Polyethylene – Stryker Triathlon X3, size 4 TS x 13mm; An Artisan Bone Plug Med was used in the tibia and femur [ 7 ]. …”
mentioning
confidence: 99%
“… Intraoperative mapping directly off of patient current implants. The implants represent native bone for the preoperative plan and registration process [ 7 ]. …”
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