Robotic‐Arm Assisted Bicompartmental Knee Arthroplasty: Durable Results up to 7‐Year Follow‐up

Author(s):  
Michael A. Gaudiani ◽  
Linsen T. Samuel ◽  
John N. Diana ◽  
Jennifer L. DeBattista ◽  
Thomas M. Coon ◽  
...  

2019 ◽  
Vol 101-B (4) ◽  
pp. 435-442 ◽  
Author(s):  
F. Zambianchi ◽  
G. Franceschi ◽  
E. Rivi ◽  
F. Banchelli ◽  
A. Marcovigi ◽  
...  

Aims The purpose of this multicentre observational study was to investigate the association between intraoperative component positioning and soft-tissue balancing on short-term clinical outcomes in patients undergoing robotic-arm assisted unicompartmental knee arthroplasty (UKA). Patients and Methods Between 2013 and 2016, 363 patients (395 knees) underwent robotic-arm assisted UKAs at two centres. Pre- and postoperatively, patients were administered Knee Injury and Osteoarthritis Score (KOOS) and Forgotten Joint Score-12 (FJS-12). Results were stratified as “good” and “bad” if KOOS/FJS-12 were more than or equal to 80. Intraoperative, post-implantation robotic data relative to CT-based components placement were collected and classified. Postoperative complications were recorded. Results Following exclusions and losses to follow-up, 334 medial robotic-arm assisted UKAs were assessed at a mean follow-up of 30.0 months (8.0 to 54.9). None of the measured parameters were associated with overall KOOS outcome. Correlations were described between specific KOOS subscales and intraoperative, post-implantation robotic data, and between FJS-12 and femoral component sagittal alignment. Three UKAs were revised, resulting in 99.0% survival at two years (95% confidence interval (CI) 97.9 to 100.0). Conclusion Although little correlation was found between intraoperative robotic data and overall clinical outcome, surgeons should consider information regarding 3D component placement and soft-tissue balancing to improve patient satisfaction. Reproducible and precise placement of components has been confirmed as essential for satisfactory clinical outcome. Cite this article: Bone Joint J 2019;101-B:435–442.



2018 ◽  
Vol 15 (3) ◽  
pp. 847-853 ◽  
Author(s):  
J. Melvin Deese ◽  
Gwen Gratto-Cox ◽  
Denny A. Carter ◽  
Thomas M. Sasser ◽  
Karah L. Brown


10.29007/nrl3 ◽  
2019 ◽  
Author(s):  
Robert Marchand ◽  
Nipun Sodhi ◽  
Hiba Anis ◽  
Joseph Ehiorobo ◽  
Jared Newman ◽  
...  

Introduction:Robotic-arm assisted (RAA) total knee arthroplasty (TKA) has been shown to potentially have certain pre- and intra-operative advantages over manual techniques. Although there are many studies on the alignment advantages when using the robotic-arm assisted (RAA) system for total knee arthroplasty (TKA), there have been questions regarding patient-reported outcomes. Therefore, the purpose of this study was to use this index to compare: 1) total; 2) physical function; and 3) pain scores for manual vs. RAA patients.Methods:We compared 53 consecutive robotic-arm assisted to 53 consecutive manual TKAs. No differences in pre-operative scores were found between the cohorts. Patients were administered a modified WOMAC satisfaction survey pre-operatively, and at 1-year post-operatively. Univariate analyses and multivariate models with stepwise backward linear regression were utilized to evaluate the associations between outcome scores and surgical technique, age, sex, as well as body mass index (BMI).Results:The RAA cohort had significantly improved mean total (6±6 vs. 9±8 points, p=0.03) and physical function scores (4±4 vs. 6±5 points, p=0.02) when compared to the manual cohort. The mean pain score for the RAA cohort [2±3 points (range, 0 to 14 points)], was also lower than that for the manual cohort [3±4 points (range, 0 to 11 points) (p=0.06)].On backward linear regression analyses, RAA was found to be significantly associated with more improved total (beta coefficient [β]-0.208, SE [standard error] 1.401, p<0.05), function (β=0.216, SE=0.829, p<0.05), and pain scores (β-0.181, SE=0.623, p=0.063). The RAA technique was found to have the strongest association with improved scores.Conclusion:With newer surgical technologies constantly being introduced, it is imperative to continue to evaluate these new modalities, particularly in their abilities to improve patient satisfaction outcomes. This study suggests that RAA patients may have short term improvements at minimum 1-year post-operative. However, longer-term follow up with greater sample sizes are needed to further validate these findings.





2020 ◽  
Vol 35 (12) ◽  
pp. 3587-3593
Author(s):  
Daniel Schrednitzki ◽  
Alexander Beier ◽  
Axel Marx ◽  
Andreas M. Halder


Author(s):  
Francesco Zambianchi ◽  
Giorgio Franceschi ◽  
Federico Banchelli ◽  
Andrea Marcovigi ◽  
Andrea Ensini ◽  
...  

AbstractThe purpose of this multicenter, retrospective, observational study was to investigate the association between intraoperative component positioning and soft tissue balancing, as reported by robotic technology for a cohort of patients who received robotic arm-assisted lateral unicompartmental knee arthroplasty (UKA) as well as short-term clinical follow-up of these patients. Between 2013 and 2016, 78 patients (79 knees) underwent robotic arm-assisted lateral UKAs at two centers. Pre- and postoperatively, patients were administered the Knee Injury and Osteoarthritis Score (KOOS) and the Forgotten Joint Score-12 (FJS-12). Clinical results were dichotomized based upon KOOS and FJS-12 scores into either excellent or fair outcome, considering excellent KOOS and FJS-12 to be greater than or equal to 90. Intraoperative, postimplantation robotic data relative to computed tomography-based components placement were collected and classified. Following exclusions and loss to follow-up, a total of 74 subjects (75 knees) who received robotic arm-assisted lateral UKAs were taken into account with an average follow-up of 36.3 months (range: 25.0–54.2 months) postoperative. Of these, 66 patients (67 knees) were included in the clinical outcome analysis. All postoperative clinical scores showed significant improvement compared with the preoperative evaluation. No association was reported between three-dimensional component positioning and soft tissue balancing throughout knee range of motion with overall KOOS, KOOS subscales, and FJS-12 scores. Lateral UKA three-dimensional placement does not seem to affect short-term clinical performance. However, precise boundaries for lateral UKA positioning and balancing should be taken into account. Robotic assistance allows surgeons to acquire real-time information regarding implant alignment and soft tissue balancing.



The Knee ◽  
2015 ◽  
Vol 22 (4) ◽  
pp. 321-327 ◽  
Author(s):  
Nicholas Eng Meng Yeo ◽  
Jerry Yongqiang Chen ◽  
Andy Yew ◽  
Shi-Lu Chia ◽  
Ngai Nung Lo ◽  
...  


Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.



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