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Robotic arm-assisted total knee arthroplasty improves preoperative planning and intraoperative decision-making
- Source :
- Journal of Orthopaedic Surgery and Research, Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-7 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central, 2021.
-
Abstract
- Background The reliability of robotic arm-assisted total knee arthroplasty (RA-TKA) has been previously reported. In this study, we evaluated the predictive accuracy of the RA-TKA system in determining the required bone resection and implant size preoperatively and its effect on intraoperative decision-making. Methods Data on the outcomes of RA-TKA procedures performed in our department were prospectively collected. A three-dimensional model of the femur, tibia, and fibula was reconstructed using standard computed tomography (CT) images. The model was used preoperatively to predict bone required resection for the femur and tibia and implant size. Intraoperatively, the images were registered to the local anatomy to create a patient-specific model for decision-making, including real-time measurement of the medial-to-lateral difference in the extension/flexion gap and TKA component alignment. Differences between predicted and real bone resections and implant size were evaluated, and the post-TKA mechanical axis of the lower limb and difference in medial-to-lateral flexion/extension gap were measured. Results The analysis was based on the data of 28 patients who underwent TKA to treat severe osteoarthritis. The RA-TKA system successfully predicted the femoral and tibial component within one implant size in 28/28 cases (100%). For the 168 bone resections performed, including both femoral and tibial cuts, the resection was within 1 mm of the predicted value in 120/168 (71%) of the cuts. The actual versus predicted bone resection was statistically different only for the lateral tibial plateau (p = 0.018). The medial-to-lateral gap difference was between − 1 and 1 mm, except in one case. The achieved lower limb alignment was accurate overall, with the alignment being within Conclusions The RA-TKA system provided considerable pre- and intraoperative surgical assistance to achieve accurate bone resection, appropriate component sizing, and postoperative alignment after RA-TKA.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
Knee Joint
Total knee arthroplasty
Preoperative TKA planning
Osteoarthritis
Diseases of the musculoskeletal system
Robotic Surgical Procedures
medicine
Humans
Robot-assisted surgery
Orthopedics and Sports Medicine
Femur
Tibia
Fibula
Arthroplasty, Replacement, Knee
Orthopedic surgery
Preoperative planning
business.industry
TKA implant sizing
Reproducibility of Results
Osteoarthritis, Knee
medicine.disease
musculoskeletal system
RC925-935
Surgery
business
Nuclear medicine
Knee Prosthesis
Robotic arm
RD701-811
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 1749799X
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Journal of Orthopaedic Surgery and Research
- Accession number :
- edsair.doi.dedup.....a96ffcccd5cb76753f7475e3b09b60eb