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Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

Ashok Kumar Podhili Subramani, MS
INDIA

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Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

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

SIMS HOSPITAL, VADAPALANI, CHENNAI, TAMIL NADU, INDIA

2023 Congress ePoster Presentation 2023 Congress rating (1)

Anatomic Location

Knee

Anatomic Structure

Bones

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Arthroplasty

Patient Populations

Elderly

Diagnosis Method

Physical Examination X-ray

Summary: Robotic Assisted Unicompartmental Knee Arthroplasty Restores Native Joint line More accurately

Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Joint line
More accurately than with Conventional Instruments?

Introduction

Alteration of the joint line position following joint replacement leads to disastrous
effects on the long-term outcomes for the patient. The semi-autonomous hand held robotic
device has increased the accuracy of component placement as planned pre-operatively. We
hypothesise that this accuracy also contributes to precise restoration of the jointline, thus
avoiding complications.
A randomised prospective cohort study of 100 patients undergoing unicompartmental knee
arthroplasty (UKA) for antero-medial osteoarthritis was initiated in March 2017 in a speciality
high volume arthroplasty unit at a tertiary care centre. All patients were clinically and
radiologically assessed with Anteroposterior scanograms, Lateral and skyline views. Limb
alignment and preoperative radiological joint line assessment was performed by 2 fellowship
trainees using Weber’s method. The patients were randomised into 2 groups and UKA was
performed either with handheld semi-autonomous robot (Group A) or by conventional UKA
instrumentation (Group B). All procedures were performed by a senior experienced surgeon. All
cases in Group A received a fixed bearing UKA while the Group B cases were implanted with a
Mobile bearing design.
Both groups were matched demographically with the average age of patients in Groups A and B
being 57.7 yrs and 59.9 yrs respectively. Both groups had a higher female representation (Group
A 70% and Group B 68.5%).
All radiological measurements were done using ImageJ (NIH, Bethesda MD). The height of the
joint line was calculated by the method described by Weber, wherein an angle was defined by a
line joining the most distal points of both femoral condyles and a second line tangent to the
lateral cortex . A successful joint line restoration was defined when the replaced
femoral component was measured within two millimetres from native joint line. The 2 millimeter
value is to compensate for the average thickness of articulating cartilage which is radiolucent.

Results

The femoral component distal positioning was higher in Group B using the conventional
instrumentation group as compared to the Group A with robotic assisted UKA. This difference in
position was statistically significant. In Group A, mean difference between the pre-operative and
post-operative joint line was 1.6± 0.49 (range 0.8mm to 2.4mm) while in Group B it was
measured at 2.47± 0.51 (range 1.6mm to 3.9mm) (p < 0.005). A higher percentage of patients
(64%) achieved a femoral component position = two millimeters from the joint line in Group A
while only 18% from Group B achieved the target.

Conclusion

The meticulous planning and attention to ligament balancing in the Robotic-
assisted UKA not only increases the surgical accuracy in implant positioning but also achieves
better native joint line restoration and balancing compared to conventional UKA technique. The
cohort needs to be followed for a longer duration to validate the longevity and survivorship.

Key words: Robotic UKA; Conventional UKA; joint line restoration
Abbreviations; UKA – UNICONDYLAR KNEE ARTHROPLASTY

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Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA
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
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
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
Total Knee Arthroplasty Without Patellar Component Replacement. Does it Increase the Risk of Revision? Local Experience Analysis ePoster Presentation Zoy Anastasiadis, MD, CHILE Diego Edwards, MD, CHILE Sergio Arellano, MD, CHILE Andrés Schmidt-Hebbel, MD, CHILE Eduardo Gardella, MD, CHILE Nicolás González-Kusjanovic, MD, MSc, CHILE Alex Vaisman, MD, Prof., CHILE
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Three-Dimensional Evaluation of Distal Femoral Valgus Angle Using Whole Leg CT in Total Knee Arthroplasty ePoster Presentation Atsushi Sato, MD, PhD, JAPAN Jun Oike, MD, PhD, JAPAN Masataka Ota, MD, JAPAN Kanako Izukashi, MD, JAPAN Saki Yagura, MD, JAPAN Takayuki Okumo, MD, PhD, JAPAN Naoki Okuma, MD, JAPAN Takayuki Koya, MD, PhD, JAPAN Fumiyoshi Kawashima, MD, JAPAN Hiroshi Takagi, MD, PhD, JAPAN Koji Kanzaki, Prof., JAPAN
Patella in Total Knee Replacement: Patellar Resurfacing has Better Outcomes than Lateral Facetectomy at One Year Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Matias Novillo, MD, ARGENTINA Tomas Nicolino, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Lisandro Carbó, MD, ARGENTINA Julian Costantini, MD, ARGENTINA
Bilateral Simultaneous Unicompartimental Knee Arthroplasty. Midterm Results in 86 Arthroplasties with an Average Follow-Up Of 6.2 Years ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Gabriel Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
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
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN

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Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

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Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments?

Introduction

Results

Conclusion

More 2023 ISAKOS Congress Content