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Imageless robotic surgery and a personalized approach: optimizing TKA after ACL reconstruction
Luca Andriollo1, Aurelio Picchi2, Gerardo Demattia3
1Unità di Chirurgia Robotica, U.O.C. Ortopedia e Traumatologia, Fondazione Poliambulanza, 25124 Brescia, Italy; Ortopedia e Traumatologia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; Artificial Intelligence Center, Alma Mater Europaea University, 1090 Vienna, Austria.
Robotic-assisted total knee arthroplasty (TKA) after anterior cruciate ligament reconstruction (ACLR) yields comparable outcomes to primary TKA. This approach safely manages TKA in patients with prior ACLR, reducing complications.
Area of Science:
- Orthopedic Surgery
- Robotic Surgery
- Knee Osteoarthritis
Background:
- Anterior cruciate ligament reconstruction (ACLR) increases the risk of knee osteoarthritis (OA) and subsequent total knee arthroplasty (TKA).
- TKA following ACLR may present increased complication rates.
Purpose of the Study:
- To evaluate imageless robotic surgery and a personalized approach for TKA in patients with a history of ACLR.
- To compare outcomes of TKA after ACLR versus primary TKA for osteoarthritis.
Main Methods:
- Prospective study of 70 patients undergoing primary TKA (35 with prior ACLR, 35 with primary OA).
- All surgeries utilized an imageless robotic system.
- Analysis included demographic, intraoperative, and postoperative data (knee function, complications, radiographic outcomes).
Main Results:
- Postoperative outcomes were comparable between ACLR and primary OA groups, despite lower preoperative function in the ACLR group.
- The ACLR group showed a residual reduction in knee flexion post-surgery.
- Higher rates of intraoperative tibial recuts were observed in the ACLR group; no major complications or revisions occurred at three-year follow-up.
Conclusions:
- Imageless robotic surgery with a personalized approach achieves comparable TKA outcomes for patients with prior ACLR versus primary OA.
- This robotic-assisted TKA approach is safe and effective, mitigating common issues in the ACLR patient cohort.
