Unicompartmental knee arthroplasty: Is robotic technology more accurate than conventional technique?

The Knee ◽  
2013 ◽  
Vol 20 (4) ◽  
pp. 268-271 ◽  
Author(s):  
Mustafa Citak ◽  
Eduardo M. Suero ◽  
Musa Citak ◽  
Nicholas J. Dunbar ◽  
Sharon H. Branch ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Conventional Technique ◽  
Robotic Technology ◽  
Unicompartmental Knee

scholarly journals Feasibility of a Novel Tibial Sighting Device Combined with Intramedullary Femoral Localisation on the Rotational Alignment of the Tibial Component for Oxford Unicompartmental Knee Arthroplasty

2020 ◽  
Author(s):  
Linjian Chen ◽  
Xiang Liu ◽  
Chaohui Li ◽  
Zhen Luo ◽  
Qiyuan Chen
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Component ◽  
Test Group ◽  
Conventional Technique ◽  
Rotational Alignment ◽  
Control Group ◽  
Tibial Osteotomy ◽  
Unicompartmental Knee ◽  
Number Of Patients

Abstract Background：The success of unicompartmental knee arthroplasty (UKA) depends on perfect prosthesis component alignment. However, it is difficult to identify the anteroposterior axis and implant components in the correct rotational position in a narrow operating field in a UKA. Thus, we invented a novel tibial sighting device and explored whether combining it with intramedullary femoral localisation could be feasible on the rotational alignment of the tibial component for the Oxford UKA.Methods: Twenty consecutive knees were treated with UKA using a novel tibial sighting device combined with intramedullary femoral localisation. An equal number of patients who underwent UKA with the conventional technique were matched to the control group. Radiographic accuracy was evaluated based on the implant position in the tibial CT transverse sections. The α angles were measured between the tibial component line and the vertical line of TEA', which was projected to the trans-epicondylar axis (TEA).Results: The absolute value of the test group’s α angle was significantly smaller than the respective values of the control group (P=0.006). The ratio of △α > 3° in the test group was also significantly smaller than that of the control group (P=0.048).Conclusion: The novel tibial sighting device combined with intramedullary femoral localisation provided the surgeon a better surgical view in sagittal tibial osteotomy and improved the accuracy of tibial implant alignment in UKA. This method makes the vertical osteotomy of the tibial platform simpler, more precise and highly repeatable.

scholarly journals Robotic-assisted Unicompartmental knee Arthroplasty optimizes joint line restitution better than conventional surgery

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Roberto Negrín ◽  
Jaime Duboy ◽  
Nicolás O. Reyes ◽  
Maximiliano Barahona ◽  
Magaly Iñiguez ◽  
...  
Keyword(s):  
Femoral Component ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Slope ◽  
Conventional Technique ◽  
Joint Line ◽  
Level Of Evidence ◽  
Robotic Assisted ◽  
Tibial Resection ◽  
Unicompartmental Knee

Abstract Purpose To compare joint line restoration after unicompartmental knee arthroplasty (UKA) between conventional and robotic-assisted surgery. Previous studies have shown that joint line distalization can lead to higher failure rates. The hypothesis was that robotic-assisted UKA is associated with less femoral component distalization and a precise tibial cut, which allows a more anatomical restitution of the knee joint line. Methods Retrospective cohort study of patients undergoing medial or lateral UKA between May 2018 and March 2020. Preoperative and postoperative radiologic assessment of the joint line was performed by two observers, using three different methods, one for tibial slope and one for tibial resection. Robotic assisted UKA and conventional UKA groups were compared. Results Sixty UKA were included, of which 48 (77.42%) were medial. Robotic-assisted UKA were 40 (64.52%) and 22(35.48%) were conventional The distalization of the femoral component was higher in the conventional group despite the method of measurement used In both Weber methods, the difference was statistically different: Conventional 2.3 (0.9 to 5.6) v/s Robotic 1.5 (− 1.1 to 4.1) (p =0.0025*). A higher proportion of patients achieved a femoral component position ≤ two millimeters from the joint line using robotic-assisted UKA compared to the conventional technique . No statistical difference between robotic-assisted and conventional UKA was found in tibial resection and slope. Conclusion Robotic-assisted UKA shows a better rate of joint line restoration due to less femoral component distalization than conventional UKA. No difference was found in the amount of tibial resection between groups in this study. Level of evidence III

scholarly journals Pinless Navigation in Unicompartmental Knee Arthroplasty

2021 ◽  
Vol 10 (11) ◽  
pp. 2422
Author(s):  
Sarah Keuntje-Perka ◽  
Philipp von von Roth ◽  
Michael Worlicek ◽  
Matthias Koch ◽  
Volker Alt ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Tibial Component ◽  
Conventional Technique ◽  
Term Survival ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
Pinless Navigation

Purpose: In contrast to total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) is a true resurfacing procedure, as none of the ligaments are replaced or released, and the pre-arthritic leg alignment is the major goal. As such, the alignment of the tibial component plays a crucial role in postoperative knee function and long-term survival. Pinless navigation has shown reliable results in total knee arthroplasty. To the best of our knowledge, the use of pinless navigation has not been investigated for UKA. Therefore, the present study investigated whether implantation of the tibial component in 3° varus, which is closer to the anatomical axis, is feasible with a pinless optical navigation system. Methods: 60 patients with the diagnosis of an unicompartmental arthritis, were eligible for UKA and treated with implantation in 3° varus alignment of the tibial component. Two groups were established. In the treatment group the tibial component was aligned using a pinless navigation technique. In the control group, a conventional extramedullary alignment guide was used. A clinical and radiographic follow up took place within 1 year of operation. Results: 57 Patients were eligible for analysis. No clinical incidents were noted in the follow up period. The desired target value, the position of the tibial component, was accurately achieved with an average of 3° medial inclination using the pinless navigation as well as using the conventional technique. Mean incision to suture time was negligible between the two techniques. The mean suture time was 43.2 min with pinless navigation and 42.7 min with the conventional technique. Conclusions: With pinless navigation in UKA, a method was presented that made it possible to achieve sled prosthesis alignment at the level of a high-volume surgeon. These results were achieved with an irrelevant increase of surgical time and without placement of pins.

Improved sizing with image-based robotic-assisted system compared to image-free and conventional techniques in medial unicompartmental knee arthroplasty

2021 ◽  
Vol 103-B (4) ◽  
pp. 610-618
Author(s):  
Cecile Batailler ◽  
Maxence Bordes ◽  
Timothy Lording ◽  
Ana Nigues ◽  
Elvire Servien ◽  
...  
Keyword(s):  
Ct Scan ◽  
Free Group ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Conventional Group ◽  
Robotic Assisted ◽  
Unicompartmental Knee ◽  
Preoperative Ct

Aims Ideal component sizing may be difficult to achieve in unicompartmental knee arthroplasty (UKA). Anatomical variants, incremental implant size, and a reduced surgical exposure may lead to over- or under-sizing of the components. The purpose of this study was to compare the accuracy of UKA sizing with robotic-assisted techniques versus a conventional surgical technique. Methods Three groups of 93 medial UKAs were assessed. The first group was performed by a conventional technique, the second group with an image-free robotic-assisted system (Image-Free group), and the last group with an image-based robotic arm-assisted system, using a preoperative CT scan (Image-Based group). There were no demographic differences between groups. We compared six parameters on postoperative radiographs to assess UKA sizing. Incorrect sizing was defined by an over- or under-sizing greater than 3 mm. Results There was a higher rate of tibial under-sizing posteriorly in the conventional group compared to robotic-assisted groups (47.3% (n = 44) in conventional group, 29% (n = 27) in Image-Free group, 6.5% (n = 6) in Image-Based group; p < 0.001), as well as a higher rate of femoral under-sizing posteriorly (30.1% (n = 28) in conventional group, 7.5% (n = 7) in Image-Free group, 12.9% (n = 12) in Image-Based group; p < 0.001). The posterior femoral offset was more often increased in the conventional group, especially in comparison to the Image-Based group (43% (n = 40) in conventional group, 30.1% (n = 28) in Image-Free group, 8.6% (n = 8) in Image-Based group; p < 0.001). There was no significant overhang of the femoral or tibial implant in any groups. Conclusion Robotic-assisted surgical techniques for medial UKA decrease the risk of tibial and femoral under-sizing, particularly with an image-based system using a preoperative CT scan. Cite this article: Bone Joint J 2021;103-B(4):610–618.

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