Summary

This study explores what may be a new field of research in knee reconstruction: a multimodal surgical procedure using both robotic and arthroscopic techniques.

Abstract

Introduction

Although bicondylar arthroplasty showed great functional results, it encounters some difficulties to be performed routinely. On the other hand, arthroscopic techniques tend to replace open surgical techniques in sports medicine, but strive to be developed in the field of arthroplasty. This study aimed to assess the feasibility of a micro-invasive bi compartmental knee arthroplasty using both arthroscopic and robotic technologies (A-BiUKA)

Material And Methods

The study was conducted on complete fresh-frozen and embalmed cadaveric specimens. The main criterion of judgment was the successful positioning of trial implants through a minimal quad-sparing approach. Arthroscopywas used for bone-morphing and burring, supported by an image-free robotic system. Secondary criteria of judgment were axial deviation, operating time, and incision length.

Results

Ten A-BiUKA were performed. Implantation was successful in all cases. The mean preoperative frontal deviation was 179.8° ± 3.2 [175 : 185], the mean postoperative frontal deviation was 178.5° ± 2.2 [175 : 182], without any outliers. The mean correction was 1.7° ± 1.6 [0 : 5]. Once the 8 first A-UKA were performed, constituting the learning curve, the mean operative time for the remaining twelves surgeries was 90 min ± 6. The mean skin incision was 3.35cm ± 0.13 [3 : 4].

Conclusion

Associated arthroscopic and robotic technologies allows new promising mini-invasive knee reconstruction surgeries competing with TKA procedures. Clinical prospective studies have to confirm the feasibility and the clinical outcomes of this surgery.