2025 ISAKOS Biennial Congress ePoster
The Femoral Cuts Correlation Between Robotic And Conventional Surgery In Total Knee Arthroplasty: A Cadaveric Study
Berta Gasol Cudos, MD SPAIN
Juan Ignacio Erquicia, MD, PhD, Sant Pere De Ribes SPAIN
Eric Camprubí, MD SPAIN
Albert Pons Riverola, MD SPAIN
Angela Zumel, PhD, Igualada SPAIN
Joan Leal-Blanquet, MD, PhD, Manresa, Barcelona SPAIN
Hospital Althaia, Xarxa assistencial Universitària de Manresa, Manresa, Barcelona, SPAIN
FDA Status Not Applicable
Summary
Robotic surgery in total knee arthroplasty has improved the accuracy of the technique. This cadaveric study aims tho assess the correlation of planned distal and rotational femoral cuts between robotic surgery and conventional techniques. Clear difference between the planned femoral cuts using robotic and conventional surgery is found.
ePosters will be available shortly before Congress
Abstract
Introduction
Precision in Total Knee Arthroplasty (TKA) is crucial for accurate implant positioning, restoration of joint balance, and leg alignment, all of which ultimately enhance prosthesis longevity and patient functionality. Advances in technology have led to the development of robotic systems that improve accuracy in TKA surgery. This study aims to assess the correlation of planned distal and rotational femoral cuts between a surgeon using the MAKO® robotic system (Stryker, Kalamazoo, MI) and those employing conventional techniques (CT).
Material And Methods
Twenty-nine knee replacements were performed on fifteen frozen cadaveric hemibodies. Preoperative computed tomography scans were conducted to facilitate surgical planning using MAKO®. A 90º tibial cut was performed on all knees to enable comparison of planned femoral cuts among surgeons. Two blinded CT surgeons -one senior and one junior- evaluated joint balancing in extension and at 90º flexion before determining the distal and femoral rotation cuts. Subsequently, another senior surgeon used MAKO® to plan the femoral cuts. Final alignment and medial and lateral stability in extension and at 90º flexion were measured using MAKO®.
Results
Sixty-seven percent of the hemibodies were male and the mean age was 77.2±13.1 years old. For the correlations of distal femoral cuts, we found a statistically significant moderate correlation between measurement of MAKO vs. CT surgeons (rho=0.46; p=0.011). However, considering the experience of the surgeon separately, we found higher correlation between MAKO vs. CT senior surgeon (rho=0.42; p=0.021) than MAKO vs. CT junior surgeon (rho=0.24; p=0.193). The correlation between CT senior vs. CT junior surgeons was low (rho=0.10; p=0.593). The mean difference between surgeons was 1.17±1.42 grades, while the mean difference between MAKO and CT surgeons was 1.67±1.35 grades. For femoral rotation cuts, we found a moderate correlation between MAKO vs. CT surgeons (rho=0.58; p=0.001), and similar moderate correlation by surgeon’s experience separately MAKO vs. CT senior surgeon (rho=0.58; p=0.001) and MAKO vs. CT junior surgeon (rho=0.40; p=0.028). We found a moderate correlation between CT surgeons for rotational femoral cut (rho=0.54; p=0.002), being 0.86±0.95 grades of mean difference between CT surgeons, while the mean difference between MAKO and CT surgeons was 2.13±1.57 grades.
Conclusion
The main finding of this cadaveric study is the clear difference between the planned femoral cuts using robotic and conventional surgery. We found a mild-moderate correlation between the two procedures, that could mean a probably less accuracy of conventional technique. Additionally we found a clear influence of the surgeon’s experience in the correlation between techniques.