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A Comparison of 90-Day Complication Rates Between Intra- and Extra-incisional Pin Sites in Robotic Total Knee
Drake G LeBrun1, Sonia K Chandi1, Colin C Neitzke1
1Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, New York.
The Journal of Arthroplasty
|January 30, 2025
Summary
Robotic-assisted total knee arthroplasty pin placement configurations showed similar primary wound complication rates. However, extra-incisional tibial pins increased the risk of tibial pin site complications.
Area of Science:
- Orthopedic Surgery
- Robotics in Medicine
- Arthroplasty
Background:
- Robotic-assisted total knee arthroplasty (TKA) requires pins for navigation arrays.
- Pins can be placed inside or outside the primary incision.
- This study compares complication rates for three pin configurations.
Purpose of the Study:
- To compare 90-day complication rates for different pin configurations in robotic TKA.
- To evaluate wound complications, manipulations under anesthesia (MUAs), and complex regional pain syndrome (CRPS).
Main Methods:
- Retrospective cohort study of 2,880 patients undergoing robotic primary TKA.
- Compared all-outside, intra-incisional femur/extra-incisional tibia, and all-inside pin groups.
- Assessed primary wound complications, pin-site complications, MUAs, and CRPS within 90 days.
Main Results:
- No significant difference in primary wound complication rates across the three groups (3.3% vs. 3.9% vs. 4.3%).
- 2.0% tibial pin-site wound complications were observed with extra-incisional tibial pins.
- No significant differences in MUA or CRPS rates between groups.
Conclusions:
- Primary wound complication rates are similar regardless of pin placement (inside or outside incision) in robotic TKA.
- Extra-incisional tibial pins are associated with an increased risk of tibial pin site complications.
- All-inside pin placement does not elevate CRPS or MUA risk compared to extra-incisional tibial pins.
