Patello-femoral joint - the forgotten third space. How can robotics help?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Robotics in Medicine

Background:

• The patello-femoral joint (third space) is crucial for knee replacement outcomes.
• Current instrumentation struggles to balance the complex third space dynamics.
• Advances in the tibio-femoral joint contrast with challenges in the patello-femoral joint.

Purpose of the Study:

• To explore advanced technologies for improving patello-femoral joint management in total knee replacement.
• To investigate the potential of robotics and digital tools in addressing the third space challenges.
• To enhance surgical precision and outcomes in the complex anterior knee region.

Main Methods:

• Utilizing robotics for 3D planning and execution of surgery based on CT scans.
• Employing novel pressure measurement systems to dynamically record patello-femoral forces.
• Investigating the impact of selective patellar bone resection on patello-femoral pressure.
• Exploring the integration of artificial intelligence for analyzing patellar movement and third space pressures.

Main Results:

• Robotics allows for precise replication and management of the complex 3D anatomy of the third space.
• A new pressure measurement system provides objective data for balancing the third space.
• Patello-femoral pressure can be modified through selective bone resection.
• AI integration shows promise in interpreting complex patellar dynamics and their effect on third space pressures.

Conclusions:

• Robotics, 3D planning, and advanced imaging offer a more effective approach to complex knee replacement surgeries.
• Objective measurement of patello-femoral forces is key to optimizing third space balance.
• Future integration of AI holds significant potential to aid surgeons in managing the intricate challenges of the patello-femoral joint.