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Postoperative limb alignment in total knee replacement. Conventional versus navigated versus robotic techniques
María Durán-Serrano1, Miguel Lizcano-Palomares1, Antonio Francisco Laclériga-Giménez1
1Cirugía Ortopédica y Traumatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, Spain.
Summary
Robotic surgery showed a higher improvement in limb alignment after total knee replacement (TKR) compared to conventional methods. However, overall post-operative alignment did not significantly differ across conventional, navigated, and robotic TKR techniques.
Area of Science:
- Orthopedic Surgery
- Biomechanical Engineering
- Medical Technology
Background:
- Accurate coronal mechanical axis alignment is crucial for successful total knee replacement (TKR).
- Different surgical techniques, including conventional, navigated, and robotic-assisted surgery, aim to optimize this alignment.
- Understanding the comparative efficacy of these methods is essential for clinical decision-making.
Purpose of the Study:
- To compare the coronal mechanical axis achieved after total knee replacement (TKR) using conventional, navigated, and robotic surgical approaches.
- To evaluate the differences in post-operative tibiofemoral angle and limb alignment among the three surgical groups.
Main Methods:
- Retrospective analysis of 124 total knee replacement (TKR) cases.
- Inclusion of three patient groups: conventional surgery (36 knees), navigated surgery (41 knees), and robotic surgery (47 knees).
- Statistical comparison of pre-operative and post-operative tibiofemoral angles and identification of outliers (3-degree deviation).
Main Results:
- No statistically significant differences in the post-operative tibiofemoral angle were observed between conventional, navigated, and robotic TKR groups (p = 0.396).
- Repeated-measure analysis also showed no significant pre-operative to post-operative alignment changes across the groups (p = 0.387).
- A significantly higher proportion of patients in the robotic group demonstrated improved mechanical alignment compared to the conventional group (p = 0.023), but not compared to the navigated group (p = 0.121).
Conclusions:
- While overall post-operative alignment did not differ significantly among the techniques, robotic surgery showed a trend towards better alignment improvement.
- Robotic-assisted TKR demonstrated a statistically significant improvement in the percentage of patients with better limb alignment compared to conventional surgery.
- Further research may be warranted to explore the long-term clinical implications of these findings in TKR outcomes.
