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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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Intraoperative Surgeon-Performed vs. Conventional Anesthesiologist-Performed Continuous Adductor Canal Block In Total Knee Arthroplasty: A Randomized Controlled Trial ePoster Presentation Chayut Chaiperm, MD, THAILAND Srihatach Ngarmukos, MD, THAILAND Aree Tanavalee, MD, THAILAND Chotetawan Tanavalee, MD, THAILAND Wirinaree Kampitak, MD, THAILAND
Participation of Physical Activity Following Knee Arthroplasty: A Meta-Analysis ePoster Presentation Ahmed A Magan, BM BSc (Hons) MRCS (Eng) FRCS (Eng) Trauma & Orth, UNITED KINGDOM Babar Kayani, BSc (HONS), MBBS, MRCS (Eng), UNITED KINGDOM Warran Wignadasan, MBBS, BSc (Hons), MRCS, UNITED KINGDOM Dia Eldean Giebaly, MBChB, MSc, FRCS, EMBA, UNITED KINGDOM Flaminia Ronca, PHD, UNITED KINGDOM Fares S. Haddad, MCh(Orth), BSc, FRCS(Orth), UNITED KINGDOM
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
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
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
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY
Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years. ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa Gabriel Gaggiotti, MD, ARGENTINA
Preoperative Bone Marrow Edema Negatively Impacts Intermediate to Long-Term Outcomes after Unicompartmental Knee Arthroplasty ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Accuracy of Advanced Active Robotic Technology for Total Knee Arthroplasty: A Cadaveric Study ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Hip-Knee-Ankle Angle Affects Medial and Lateral Tibiofemoral Compressive Forces More Significantly than Joint Line Obliquity in Patients Post Total Knee Arthroplasty ePoster Presentation David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, 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
Time-Driven Activity-Based Costs for Manipulation Under Anesthesia after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES John Mazzocco, MD, UNITED STATES Lauren Schoeller, BS, UNITED STATES Ruijia Niu, MPH, UNITED STATES Daniel C Sun, UNITED STATES Eric L. Smith, MD, UNITED STATES

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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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Conclusion

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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