23
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Robotic Total Knee Arthroplasty with a Cruciate-Retaining Implant: A 10-Year Follow-up Study

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          This study compared clinical and radiological results between robotic total knee arthroplasty (TKA) and conventional TKA with a cruciate-retaining implant at 10-year follow-up. The hypothesis was that robotic TKA would allow for more accurate leg alignment and component placement, and thus enhance clinical and radiological results and long-term survival rates.

          Methods

          A total of 113 primary TKAs performed using a cruciate-retaining implant in 102 patients from 2004 to 2007 were reviewed retrospectively. Of the 113 TKAs, 71 were robotic TKAs and 42 were conventional TKAs. Clinical outcomes (visual analogue scale pain score, Hospital for Special Surgery score, Western Ontario and McMaster University score, range of motion, and complications), radiological outcomes, and long-term survival rates were evaluated at a mean follow-up of 10 years.

          Results

          Clinical outcomes and long-term survival rates were similar between the two groups. Regarding the radiological outcomes, the robotic TKA group had significantly fewer postoperative leg alignment outliers (femoral coronal inclination, tibial coronal inclination, femoral sagittal inclination, tibial sagittal inclination, and mechanical axis) and fewer radiolucent lines than the conventional TKA group.

          Conclusions

          Both robotic and conventional TKAs resulted in good clinical outcomes and postoperative leg alignments. Robotic TKA appeared to reduce the incidence of leg alignment outliers and radiolucent lines compared to conventional TKA.

          Related collections

          Most cited references25

          • Record: found
          • Abstract: found
          • Article: not found

          Coronal alignment after total knee replacement.

          Maquet's line passes from the centre of the femoral head to the centre of the body of the talus. The distance of this line from the centre of the knee on a long-leg radiograph provides the most accurate measure of coronal alignment. Malalignment causes abnormal forces which may lead to loosening after knee replacement. We report a series of 115 Denham knee replacements performed between 1976 and 1981 using the earliest design of components, inserted with intramedullary guide rods. Patients were assessed clinically and long-leg standing radiographs were taken before operation, soon after surgery and up to 12 years later. In two-thirds of the knees (68%) Maquet's line passed through the middle third of the prosthesis on postoperative films and the incidence of subsequent loosening was 3%. When Maquet's line was medial or lateral to this, an error of approximately +/- 3 degrees, the incidence of loosening at a median period of eight years was 24%. This difference is highly significant (p = 0.001). Accurate coronal alignment appears to be an important factor in prevention of loosening. Means of improving the accuracy of alignment and of measuring it on long-leg radiographs are discussed.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Postoperative alignment of total knee replacement. Its effect on survival.

            Four hundred twenty-one posterior cruciate condylar total knee arthroplasties were performed between 1975 and 1983. Anatomic alignment of the knee was recorded on follow-up evaluations from two months to 13 years postoperatively. Patients were stratified into a normal group that was 5 degrees to 8 degrees anatomic valgus, a varus group that was from 4 degrees anatomic valgus to any degree of varus, and a valgus group that was more than 9 degrees anatomic valgus. There were eight failures, five in the varus group and three in the normal group. There were no failures in the valgus group. Kaplan-Meier survival curves showed no significant difference between normal and valgus groups; however, there was a statistical difference between the valgus and varus and the normal and varus groups. A surgeon should align a total knee prosthesis in neutral or a slight amount of anatomic valgus to give the patient the best chance for long-term survival.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Robotics in Arthroplasty: A Comprehensive Review

              Robotic-assisted orthopedic surgery has been available clinically in some form for over 2 decades, claiming to improve total joint arthroplasty by enhancing the surgeon's ability to reproduce alignment and therefore better restore normal kinematics. Various current systems include a robotic arm, robotic-guided cutting jigs, and robotic milling systems with a diversity of different navigation strategies using active, semiactive, or passive control systems. Semiactive systems have become dominant, providing a haptic window through which the surgeon is able to consistently prepare an arthroplasty based on preoperative planning. A review of previous designs and clinical studies demonstrate that these robotic systems decrease variability and increase precision, primarily focusing on component positioning and alignment. Some early clinical results indicate decreased revision rates and improved patient satisfaction with robotic-assisted arthroplasty. The future design objectives include precise planning and even further improved consistent intraoperative execution. Despite this cautious optimism, many still wonder whether robotics will ultimately increase cost and operative time without objectively improving outcomes. Over the long term, every industry that has seen robotic technology be introduced, ultimately has shown an increase in production capacity, improved accuracy and precision, and lower cost. A new generation of robotic systems is now being introduced into the arthroplasty arena, and early results with unicompartmental knee arthroplasty and total hip arthroplasty have demonstrated improved accuracy of placement, improved satisfaction, and reduced complications. Further studies are needed to confirm the cost effectiveness of these technologies.
                Bookmark

                Author and article information

                Journal
                Clin Orthop Surg
                Clin Orthop Surg
                CIOS
                Clinics in Orthopedic Surgery
                The Korean Orthopaedic Association
                2005-291X
                2005-4408
                June 2017
                08 May 2017
                : 9
                : 2
                : 169-176
                Affiliations
                [* ]Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Bitgoeul Hospital, Gwangju, Korea.
                []Chonnam National University Research Institute of Medical Science, Gwangju, Korea.
                Author notes
                Correspondence to: Eun Kyoo Song, MD. Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University Bitgoeul Hospital, 80 Deongnam-gil, Nam-gu, Gwangju 61748, Korea. Tel: +82-61-379-7677, Fax: +82-61-379-7681, Chonnam National University, Research Institute of Medical Sciences, 264 Seoyang-ro, Hwasun 58128, Korea. Tel: +82-61-379-2881, Fax: +82-61-379-2890, eksong@ 123456chonnam.ac.kr
                Article
                10.4055/cios.2017.9.2.169
                5435654
                28567218
                903a4fd0-75fd-49ee-b5e3-d86ee724f5a9
                Copyright © 2017 by The Korean Orthopaedic Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 October 2016
                : 28 February 2017
                Funding
                Funded by: Chonnam National University, CrossRef http://dx.doi.org/10.13039/501100002456;
                Award ID: 2010-CURIMS-DR004
                Categories
                Original Article

                Surgery
                arthroplasty,robotics,knee,conventional
                Surgery
                arthroplasty, robotics, knee, conventional

                Comments

                Comment on this article