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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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Knee Arthroscopy Prior to UKA Does Not Cause Infection ePoster Presentation Kevin D. Plancher, MD, MPH, UNITED STATES Karen Briggs, MPH, UNITED STATES Stephanie C. Petterson, MPT, PhD, UNITED STATES
Subtalar Joint Compensation using Full-length Standing Lower Extremity Anteroposterior Radiograph after Total Knee Arthroplasty for Varus Osteoarthritis in Nara Medical University Hospital with 2-year Follow-up ePoster Presentation Jerre Co De Guzman, MD, PHILIPPINES Munehiro Ogawa, MD, PhD, JAPAN Yusuke Ozaki, MD, JAPAN Yasuhito Tanaka, Prof., JAPAN Yuki Nishimura, MD, JAPAN Maria Elizabeth Mercado, MD, MAS, PHILIPPINES
The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty ePoster Presentation Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, 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
Incidence and Prevention of Deep Vein Thrombosis Using Thromboprophylaxis in Total Knee Replacement: A Prospective Clinical Study ePoster Presentation Amit Lakhani, MS, DNB, MRCPS(Glassg), MNAS, INDIA
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF
Comparative Analysis Of Time Taken In Conventional vs. Robotic Assisted Total Knee Arthroplast ePoster Presentation Sanjay B. Londhe, MS, FRCS, FRCSI, MCh, INDIA Santosh Chandrashekar Shetty, MS, INDIA Ashit Hasmukhbhai Shah, FRCS Orth, M ChOrth, M S Orth, D N B Orth, INDIA Niraj Vora, MS,MRCS, INDIA Vijay Shetty, MD, MSc, FRCSC, INDIA Rakesh Nair, MS, INDIA Clevio Joao Baptista Desouza, MD, INDIA Farheen Khan, B.Tech, INDIA
Bicruciate Substituting Total Knee Arthroplasty Improved Anteroposterior Displacement in Mid-Flexion Range ePoster Presentation Keinosuke Ryu, Prof., JAPAN Takanori Iriuchisima, MD, JAPAN
Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA ePoster Presentation Manabu Akagawa, MD, PhD, JAPAN ヒデトモサイトウ, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
Treatment of Periprosthetic Infection after Total Knee Arthroplasty using an Ultrastatic Spacer ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES Ruijia Niu, MPH, UNITED STATES Ayesha Abdeen, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES
In-Vivo Kinematic Analysis of Evolution® Medial-Pivot Total Knee Arthroplasty during Weight-Bearing Activity ePoster Presentation Eiichi Nakamura, MD, PhD, JAPAN Nobukazu Okamoto, MD, PhD, JAPAN Hitoshi Ito, MD, PhD, JAPAN Tetsurou Masuda, MD, PhD, JAPAN Satoshi Hisanaga, MD, PhD, JAPAN Yasunari Oniki, MD, PhD, JAPAN

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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