Robotic-Assisted Total Knee Arthroplasty Can Increase Frequency of Achieving Target Limb Alignment in Primary Total Knee Arthroplasty for Preoperative Valgus Deformity

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2023 Sep 25

PMID 37745954

Authors

Austin E Wininger

Bradley S Lambert

Thomas C Sullivan

Timothy S Brown

Stephen J Incavo

Kwan J Park

Affiliations

Soon will be listed here.

Abstract

Background: Robotic-assisted total knee arthroplasty (rTKA) has been shown to reduce the number of alignment outliers and to improve component positioning compared to manual TKA (mTKA). The primary purpose of this investigation was to compare the frequency of achieving target postoperative limb alignment and component positioning for rTKA vs mTKA.

Methods: A retrospective comparative study was performed on 250 patients undergoing primary TKA by 2 fellowship-trained arthroplasty surgeons. Surgeon A performed predominantly rTKA (103 cases) with the ROSA system (Zimmer Biomet, Warsaw, IN) and less frequently mTKA (44 cases) with conventional instrumentation. Surgeon B performed only mTKA (103 cases). Target limb alignment for surgeon A was 0° for all cases and for surgeon B was 2° varus for varus knees and 0° for valgus knees. Radiographic measurements were determined by 2 reviewers. Target zone was set at ± 2 degrees from the predefined target.

Results: When comparing rTKA to mTKA performed by different surgeons, there were no differences in the percentage within the target zone (57.28% vs 53.40%, = .575), but rTKA did result in a greater percentage for cases with preoperative valgus (71.42% vs 44.12%, = .031). Patient-reported Outcomes Measurement Information System Global-10 physical scores were statistically higher at both 3 ( = .016) and 6 months ( = .001) postoperatively for rTKA compared to mTKA performed by different surgeons.

Conclusions: Although experienced surgeons can achieve target limb alignment correction with similar frequency when comparing rTKA to mTKA for all cases, rTKA may achieve target limb alignment with more accuracy for preoperative valgus deformity.

Level Of Evidence: Retrospective Cohort Study, Level III.

Citing Articles

Does robotic surgical assistant (ROSA) functionally aligned TKA lead to higher satisfaction than conventional mechanically aligned TKA: A propensity-matched pair analysis.

Zhang E, Yeo W, Liu E, Chen J, Pang H, Yeo S J Orthop. 2024; 63:93-97.

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DEIT-Based Bone Position and Orientation Estimation for Robotic Support in Total Knee Arthroplasty-A Computational Feasibility Study.

Schrott J, Affortunati S, Stadler C, Hintermuller C Sensors (Basel). 2024; 24(16).

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