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Robotic-assisted total knee arthroplasty improves accuracy and precision compared to conventional techniques
David G Deckey1, Christian S Rosenow2, Jens T Verhey2
1Department of Orthopaedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, USA.
The Bone & Joint Journal
|May 31, 2021
Summary
Robotic-assisted total knee arthroplasty (RA-TKA) demonstrates superior accuracy and precision in component positioning and polyethylene insert thickness compared to mechanical instrument total knee arthroplasty (M-TKA). This enhanced precision may lead to improved patient outcomes in knee replacement surgery.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Robotics in Medicine
Background:
- Robotic-assisted total knee arthroplasty (RA-TKA) offers theoretical advantages in component positioning accuracy over traditional mechanical instrument total knee arthroplasty (M-TKA).
- RA-TKA's ability to integrate soft-tissue data pre-operatively may reduce variability in polyethylene insert thickness.
- Accurate component placement and appropriate implant sizing are crucial for successful TKA outcomes.
Purpose of the Study:
- To compare the accuracy of component positioning in RA-TKA versus M-TKA.
- To evaluate the precision of polyethylene insert thickness in RA-TKA compared to M-TKA.
- To assess deviations from the surgical plan for both component placement and implant size.
Main Methods:
- A retrospective review of 220 primary total knee arthroplasties (TKAs) performed by a single surgeon was conducted.
- Data from 103 M-TKAs and 96 RA-TKAs were analyzed for deviations in femoral and tibial component positioning, tibial posterior slope, limb alignment, and polyethylene insert thickness.
- Statistical analysis compared mean deviations and outliers between the RA-TKA and M-TKA groups.
Main Results:
- RA-TKA showed significantly smaller deviations from the planned component positioning (femoral, tibial, posterior slope, limb alignment) compared to M-TKA (p < 0.001).
- Fewer RA-TKA cases required distal femoral recuts (10% vs. 22%, p = 0.033).
- Deviation from the planned polyethylene insert thickness was significantly less in the RA-TKA group (p < 0.001).
Conclusions:
- Robotic-assisted total knee arthroplasty (RA-TKA) provides significantly greater accuracy and precision in component positioning and polyethylene insert thickness than M-TKA.
- The enhanced accuracy and reproducibility of RA-TKA are valuable as patient-specific alignment goals evolve.
- Further research is warranted to determine if RA-TKA's improved accuracy translates to better clinical outcomes.
