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Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

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Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN

Tokushima University Graduate School, Tokushima, Tokushima, JAPAN

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Bones

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Arthroplasty Total Joint Replacement

Summary: Functionally aligned robotic-assisted BCS TKA showed better postoperative 2011 KSS items of objective knee indicators, symptoms, patient satisfaction and functional activities compared to that of mechanically aligned navigation-assisted BCS TKA.

Objective

Traditionally, a postoperative neutral mechanical alignment was the gold standard in total knee arthroplasty (TKA) and mechanically aligned TKA has achieved good long-term survival. However, recent study demonstrated the variety of coronal alignment in non-arthritic population and raises a question whether post-operative neutral alignment is not a target for all patients. To resolve this issue, a couple of personalized alignment such as kinematic alignment, restricted kinematic alignment, inverse kinematic alignment, and functional alignment has been proposed. Furthermore, recently introduced robotic technologies accelerate the surgery based on the personalized alignment in TKA. The purpose of this study is to compare the clinical outcome of mechanically aligned navigation-assisted TKA and functionally aligned robotic-assisted TKA.

Methods

A total of 121 bicruciate-stabilized (BCS) TKA was included in this study. Fifty-nine knees were navigation-assisted TKA and sixty-two knees were robotic-assisted TKA. In navigation group, the target alignment was neutral mechanical alignment of which distal femur and proximal tibia was cut perpendicular to the mechanical axis. In robotics group, image-free handheld robotics was used. The initial intraoperative plan started from neutral mechanical alignment. After gap evaluation using robotics, the plan of implant position was manipulated to minimize the soft tissue imbalance while limb alignment must fall within ± 3 degrees of neutral in coronal plane. After surgeon approved the final plan, femur and tibia were cut using robotically controlled handheld bur. A long-standing anteroposterior radiograph was used to measure pre and postoperative hip-knee-ankle angle (HKA). To evaluate patient-reported outcome measures, 2011 Knee Society Score (KSS) was recorded before and 1-year after surgery. Unpaired t-test was used to evaluate differences between navigation and robotics. The level of significance was set at p < 0.05 for all tests. This study was approved by the institutional review board.

Results

Preoperative patient demographics (age, gender, BMI, disease, ROM, HKA and 2011 KSS) were not different between groups. Postoperative HKA was significantly varus in robotics group (navigation, 179.4 ± 2.2°; robotics, 178.4 ± 2.7°). The mean postoperative 2011 KSS for objective knee indicators, symptoms, patient satisfaction and functional activities were significantly better in robotics group (72.9 vs 74.5, 18.8 vs 20.9, 26.5 vs 29.8, 59.9 vs 69.1, respectively). Postoperative extension and flexion angle were not different between groups.

Conclusion

Functionally aligned robotic-assisted BCS TKA showed better postoperative 2011 KSS items of objective knee indicators, symptoms, patient satisfaction and functional activities compared to that of mechanically aligned navigation-assisted BCS TKA. On the other hand, postoperative ROM was comparative between groups. Personalized alignment using robotics potentially provides better clinical outcome than uniform mechanical alignment for all cases. Differences between navigation and robotics such as limb alignment, soft tissue balance, bone resection volume, joint line obliquity may affect the results. Further study to investigate which factor affect this result is necessary.

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Short Term Outcome of Tibial Defect Reconstruction In Primary Total Knee Arthroplasty: A Retrospective Study ePoster Presentation Sanjib Kumar Behera, MS (Orth), DNB (Rehab), DPMR, INDIA Madhumita Pradhan, BDS, MPH, MHA , INDIA Vikram Choudhary, MD, UNITED STATES
Large Reduction In Postoperative Posterior Tibial Slope Risks Anterior Collapse Of The Tibial Component In Fixed-Bearing Unicompartmental Knee Arthroplasty ePoster Presentation Kazuhisa Hatayama, MD, PhD, JAPAN Masanori Terauchi, MD, JAPAN Shingo Kurihara, MD, JAPAN Satoshi Nonaka, MD, JAPAN Hibiki Kakiage, MD, JAPAN
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty. ePoster Presentation Ryota Yamagami, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Takahiro Arakawa, MD, JAPAN Hiroshi Inui, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Association Of Ischemia Time And Serum Lactate Levels With Postoperative Pain In Primary Total Knee Arthroplasty At The Orthopedics And Traumatology Service At The Unidad Médica De Alta Especialidad No. 1 Bajío. ePoster Presentation Juan Antonio García Ramírez, MD, MEXICO
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Central Sensitization is Associated with Persistent Postoperative Pain and Inferior Patient-Reported Outcomes in Patients Undergoing Unicompartmental Knee Arthroplasty ePoster Presentation Yong In, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
Patellofemoral Arthroplasty In Community Programs: Case Series of 425 Patients ePoster Presentation Alexander P. Sah, MD, UNITED STATES
High Cure Rate In Hematogenous TKA PJI At A Long-Term Follow-Up By Means Of Dair Procedure ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN Pedro Hinarejos, MD, PhD, SPAIN
Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments? ePoster Presentation Ashok Kumar Podhili Subramani, MS, INDIA Shantanu S. Patil, MBBS, MS(Orth), INDIA SAWAN PAWAR, MBBS MS (ORTH), INDIA Kalaivanan Kanniyan, MBBS MS Orth, INDIA karthik jayachandran, MS, INDIA PICHAI SURYANARAYAN, MBBS MS ORTH, INDIA

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Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

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Conclusion

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Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA

Objective

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content