2
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Robotic-assisted differential total knee arthroplasty with patient-specific implants: surgical techniques and preliminary results

      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

          Objective

          In total knee arthroplasty (TKA), achieving soft-tissue balance while retaining acceptable lower limb alignment is sometimes difficult and may lead to patient dissatisfaction. Theoretically, patient-specific implants can bring great benefits, while the lack of precise surgical tools may hinder the improvement of outcomes. The objective of this study was to illustrate surgical techniques and evaluate kinematics and early clinical outcomes of robotic-assisted TKA using patient-specific implants.

          Methods

          Based on preoperative CT scan, femoral and tibial components were 3D printed. Medial and lateral tibial liners were separate with different thicknesses, posterior slopes and conformity. TiRobot Recon Robot was used for surgery, and was armed with smart tools that quantify gap, force and femoral-tibial track. We collected data on demographics, intraoperative gap balance and femoral-tibial motion. In the follow-up, we evaluated the range of motion, Visual Analogue Scale (VAS), forgotten joint score (FJS), Knee injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR) score. Radiological data were also harvested.

          Results

          Fifteen patients (17 knees) were enrolled with a mean age of 64.6 ± 6.4 (53–76) years. In 5 knees, we used symmetric tibial liners, the rest were asymmetric. After surgery, the average alignment was 1.6 ± 2.0 (-3–5) degrees varus. The average follow-up lasted 6.7 ± 4.2 (1–14) months. The mean visual analogue scale was 0.8 ± 0.7 (0–2), FJS was 62.4 ± 25.3 (0–87), KOOS was 86.5 ± 9.4 (57–97). 11 patients were “very satisfied”, 3 were “satisfied" with the result, and one patient was neutral due to restricted extension and unsatisfactory rehabilitation at five months’ follow-up.

          Conclusions

          With patient-specific implants and robotics, TKA could be performed by a mathematical way, which was dubbed a “differential” TKA. Intraoperative kinematics was excellent in terms of gap-force balancing and femoral-tibial relative motion. Preliminary clinical outcomes were overall satisfactory.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s42836-024-00255-1.

          Related collections

          Most cited references24

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

          Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes

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

            MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review

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

              Patient-specific implants with custom cutting blocks better approximate natural knee kinematics than standard TKA without custom cutting blocks.

              Nearly 14% to 39% TKA patients report dissatisfaction causing incomplete return of function. We proposed that the kinematics of knees implanted with patient-specific prostheses using patient-specific cutting guides would be closer to normal.
                Bookmark

                Author and article information

                Contributors
                orthoyixin@yahoo.com
                Journal
                Arthroplasty
                Arthroplasty
                Arthroplasty
                BioMed Central (London )
                2524-7948
                10 June 2024
                10 June 2024
                2024
                : 6
                : 34
                Affiliations
                GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Orthopaedic Surgery, , Beijing Jishuitan Hospital, Capital Medical University, ; No. 31, Xinjiekou East Street, Xicheng District, Beijing, 100035 China
                Author information
                http://orcid.org/0000-0002-9682-0577
                Article
                255
                10.1186/s42836-024-00255-1
                11163793
                38853256
                ec8220d0-3139-4c0e-9064-90796b331ffd
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 19 January 2024
                : 9 April 2024
                Categories
                Research
                Custom metadata
                © Arthroplasty Society in Asia 2024

                total knee arthroplasty,patient-specific,customized,soft-tissue,gap balancing

                Comments

                Comment on this article