Intraincisional Pin Placement is Safe for Robotic-Assisted Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Arthroplasty

Background:

• Robotic-arm assisted total knee arthroplasty (RA-TKA) utilization is increasing.
• RA-TKA typically requires bone array pins, posing inherent risks.
• Intraincisional pin placement is an off-label technique with limited safety data.

Purpose of the Study:

• To evaluate the safety and complication rates of intraincisional pin placement in RA-TKA.
• To assess the incidence of periprosthetic fractures and infections associated with this technique.
• To determine the 1-year reoperation rate following RA-TKA using intraincisional pins.

Main Methods:

• Prospective cohort study of 2,343 patients undergoing RA-TKA.
• Inclusion of patients from January 2018 to March 2022.
• Assessment of primary outcomes (fracture, infection) and secondary outcomes (reoperation rate) with 90-day and 1-year follow-ups.

Main Results:

• Pin-site related periprosthetic fracture incidence was 0.09% at 90 days.
• 90-day infection incidence was 1.4% (superficial and deep).
• The 1-year reoperation rate was 1.8%, with deep infection being the most common cause.

Conclusions:

• Intraincisional pin placement in RA-TKA is associated with a low risk of pin-related periprosthetic fracture (1 in 1,172 patients).
• The study found a low 90-day infection incidence.
• Reoperations within 1 year after RA-TKA with this technique were rare.