scholarly journals Predictability of implants size in Robotic Surgery for Total Knee and hip Replacement Arthroplasty

10.29007/wn1n ◽  
2020 ◽  
Author(s):  
Kamal Deep ◽  
Frederic Picard ◽  
Shoaib Iqbal
Keyword(s):  
Robotic Surgery ◽  
Hip Replacement ◽  
Computer Assisted ◽  
Acetabular Cup ◽  
Joint Replacements ◽  
Assisted Navigation ◽  
Replacement Arthroplasty ◽  
Implant Size ◽  
Operative Planning ◽  
Total Knee

Accuracy of implantation using computer assisted navigation and robotic total knee replacement arthroplasty (TKR) and total hip replacement (THR) has been proven. Templating the pre-operative radiographs has become standard. This gives an insight into the pre op planning and the sizes most likely to be used. This helps to reduce the inventory for storage of implants and cost. While the templating of radiographs has been helpful, implant sizes prediction remains less than desirable. Aim of present study was to look at the predictability of implant sizes in CT planning for robotic surgery. 30 MAKO robotic joint replacements were performed (15TKR/15THR) with pre op CT scans for implant size. For TKR, the sizes used were mean 5 in femur and tibia (SD1 and range 3-7). In tibia, size used was same as predicted. In the femur in two cases the size was reduced by one to balance the gaps. Insert thickness was increased by one size in 4 cases. For THR, the acetabular cup, femur, head diameter and offset were predicted 100%. The neck length had to be changed in some cases by up to two sizes. for balance/stability. In conclusion the CT scan pre-operative planning for MAKO robotic knee joint replacement can predict 100% times the size of tibia, within one size of femur and insert for TKR. These figures are better than published predictability of templates of plain radiographs where implant size was predicted 42% for femoral and 37% acetabular components while 87% of the femoral components and 78% of the acetabular cups were accurate within one size up and down.

scholarly journals A Detailed analysis of Time taken in Robotic Surgery for Total Knee Replacement Arthroplasty and comparison with computer assisted navigation in Total Knee Replacement Arthroplasty

10.29007/65qr ◽  
2020 ◽  
Author(s):  
Kamal Deep ◽  
Frederic Picard
Keyword(s):  
Total Knee Replacement ◽  
Ct Scan ◽  
Knee Replacement ◽  
Soft Tissues ◽  
Computer Navigation ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Replacement Arthroplasty ◽  
Knee Replacement Arthroplasty ◽  
Total Knee

The accuracy of implantation using computer navigation and robotic total knee replacement (TKR) has been proven. Time taken during surgery has been a factor for surgeons for not using the technology. Aim of this study was to analyse time taken in different steps and identify which part needs improvement. Robotic time was compared to computer navigation. Methods: 15TKR were performed with MAKO robot. Software for the ligament balancing was used. All had CT scan preoperatively. Time of different surgical steps was recorded. Time for computer navigation was recorded too. After joint exposure, trackers and verification pins for tibia and femur were inserted. Femoral registration matching started at 10.8 minutes (SD3.3 Range7-20). It took 3.2 minutes to match femoral anatomy to CT scan. Tibial registration done at 14.1minutes (SD3 Range10- 23). Once matching was accepted to required accuracy, tibial cut was made at 22.2 minutes (SD4.4 Range 15-30). Next the soft tissues were assessed with tensioner. It took 6.3 minutes (SD 5.6). Final femoral preparation done at 35.7 minutes (SD 5.6 Range25-45). Trial performed at 52 minutes (SD7.3 Range42-63). Implants were cemented at 63.4 minutes (SD8 Range50-72). Wound closed at 77.6 minutes (SD9.5 Range65-97). The computer navigated TKR surgery took 70 minutes on an average. Compared to navigation, robotic technique took approximately 7 minutes longer, not significantly different. This could be due to learning curve of the surgical and theatre team. Improvement is required in different steps. The familiarity of staff will increase the efficiency. Registration matching took 11.4 minutes. Femoral preparation took 17 minutes. These steps could be streamlined.

scholarly journals A Detailed analysis of Time taken in Robotic Surgery for Total Hip Replacement Arthroplasty and comparison with computer assisted navigation in Total Hip Replacement Arthroplasty

10.29007/9mwf ◽  
2020 ◽  
Author(s):  
Kamal Deep
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Computer Navigation ◽  
Computer Assisted ◽  
Hip Replacement Arthroplasty ◽  
Assisted Navigation ◽  
Total Hip ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Replacement Arthroplasty

The accuracy of implantation using navigation and robotic hip replacement (THR) has been proven and accepted. Time taken for the use of technology, has been one of the major factors quoted by many surgeons for not using it. Aim was to analyse the time taken during different steps of the procedure and identify which part needs further improvement. Secondary aim was to compare the time with computer navigation technology. 20 total joint replacements were carried out with MAKO robotic system using extended software version, which includes both acetabular and femoral guidance. The times of different surgical steps were noted. After the incision was made, and joint exposed the trackers for the pelvis and femur were then inserted, tightened and verification pins inserted. Femoral registration matching was started at 15 minutes (SD5.4 Range7-22). Femoral Neck Cut level was made at 22.5 minutes (SD4.5 Range15-29). It took mean 7.5 minutes to match the femoral anatomy to preop CT scan anatomy. Pelvic registration matching was done at 42.4 minutes (SD5.9 Range33-50). It took average 8.4 minutes to match pelvic anatomy. Bone reaming was with robotic arm at 50.8minutes (SD5.5 Range40-57). The cup was impacted at 56.2 minutes (SD5.2 Range45-60). Cementing stem added 14 minutes. The navigation hip replacement surgery took mean 60 minutes in uncemented and 72minutes for cemented stems. Robotic technique took 10 minutes longer. There is room for improvement in two main modifiable steps. Total registration matching time which took 16 minutes and using a uncemented stem. Should time constraint supersede accuracy achievable with technology?

Navigation in Computer Assisted Orthopaedic Surgery

2011 ◽  
pp. 205-222 ◽  
Author(s):  
Elena De Momi ◽  
Pietro Cerveri ◽  
Giancarlo Ferrigno
Keyword(s):  
Hip Replacement ◽  
Computer Assisted Surgery ◽  
Quantitative Information ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Innovative Methods ◽  
Computer Assisted Orthopaedic Surgery ◽  
Operative Planning ◽  
Total Knee ◽  
Accuracy And Repeatability

Originally developed for neurosurgery procedures, since late nineties Computer Assisted Surgery (CAS) systems have been used in orthopaedic interventions. Such systems assist the surgeon during the preoperative or the intra-operative planning phase from diagnostic data, during the intra-operative phases of registration and navigation. They provide quantitative information of the overall surgical outcome and allow controlling range of accuracy and repeatability. Despite recognized advance in introducing the computer in the orthopaedic operative room (OR), several aspects are still debated such as operative time prolongation, information provided to the surgeon and user interface management. The chapter is aimed at reviewing main navigation systems as far as the visual and interactive aspects are concerned and at suggesting useful tools in order to enhance the surgeon usability of a navigation system. We developed modules for Total Knee Replacement (TKR) and Total Hip Replacement (THR), named KneeLab and HipLab respectively. In the two applications, we coped with two main aspects of the navigation in knee and hip replacement combining new visualization methods and new working methods. In the chapter, the reader can find a detailed description of the solution proposed to overcome problems commonly found with navigation systems in orthopaedics. We introduced innovative methods and algorithms, new modality of vocal interface, fully 3D graphics, recovery session from file system. The development aimed at the fulfilment of the critical user requirements of the operating room, by providing the user with a tightly guided procedure and an immediate graphical virtual environment.

scholarly journals Reliability of Imageless Computer-Assisted Navigation for Femoral Rotational Alignment in Total Knee Arthroplasty

2021 ◽  
Vol 15 (1) ◽  
pp. 79-84
Author(s):  
Leelasestaporn C ◽  
Thuwapitchayanant M ◽  
Sirithanapipat P ◽  
Sa-ngasoongsong P ◽  
Ruengsilsuwit P
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Knee

scholarly journals Computer assisted navigation in total knee and hip arthroplasty

SICOT-J ◽  
2017 ◽  
Vol 3 ◽  
pp. 50 ◽  
Author(s):  
Kamal Deep ◽  
Shivakumar Shankar ◽  
Ashish Mahendra
Keyword(s):  
Hip Arthroplasty ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Knee ◽  
Knee And Hip Arthroplasty

scholarly journals Accuracy of femoral rotational alignment in total knee arthroplasty using computer assisted navigation

2008 ◽  
Vol 13 (3) ◽  
pp. 167-172 ◽  
Author(s):  
Camilo Restrepo ◽  
William J. Hozack ◽  
Fabio Orozco ◽  
Javad Parvizi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Knee

scholarly journals Conventional versus Smart Wireless Navigation in Total Knee Replacement: Similar Outcomes in a Randomized Prospective Study

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 090-094 ◽  
Author(s):  
Matteo Denti ◽  
Francesco Soldati ◽  
Francesca Bartolucci ◽  
Emanuela Morenghi ◽  
Laura De Girolamo ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Tibial Slope ◽  
Computer Assisted ◽  
Level Of Evidence ◽  
Assisted Navigation ◽  
Level Ii ◽  
Before And After ◽  
Total Knee ◽  
Generation Computer ◽  
Navigated Tka

Purpose The development of new computer-assisted navigation technologies in total knee arthroplasty (TKA) has attracted great interest; however, the debate remains open as to the real reliability of these systems. We compared conventional TKA with last generation computer-navigated TKA to find out if navigation can reach better radiographic and clinical outcomes. Methods Twenty patients with tricompartmental knee osteoarthritis were prospectively selected for conventional TKA (n = 10) or last generation computer-navigated TKA (n = 10). Data regarding age, gender, operated side, and previous surgery were collected. All 20 patients received the same cemented posterior-stabilized TKA. The same surgical instrumentation, including alignment and cutting guides, was used for both the techniques. A single radiologist assessed mechanical alignment and tibial slope before and after surgery. A single orthopaedic surgeon performed clinical evaluation at 1 year after the surgery. Wilcoxon's test was used to compare the outcomes of the two groups. Statistical significance was set at p < 0.05. Results No significant differences in mechanical axis or tibial slope was found between the two groups. The clinical outcome was equally good with both techniques. At a mean follow-up of 15.5 months (range, 13–25 months), all patients from both groups were generally satisfied with a full return to daily activities and without a significance difference between them. Conclusion Our data showed that clinical and radiological outcomes of TKA were not improved by the use of computer-assisted instruments, and that the elevated costs of the system are not warranted. Level of Evidence This is a Level II, randomized clinical trial.

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