Surgical accuracy of image-free versus image-based robotic-assisted total knee arthroplasty

Dennis King-Hang Yee, Jonathan Patrick Ng, Cyrus Tsun-Kit Lau, Kevin Ki-Wai Ho, Gene Chi-Wai Man, Vikki Wing-Shan Chu, Tsz Lung Choi, Gloria Yan Ting Lam, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
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Abstract

Background

This study investigated the accuracy in achieving proper lower limb alignment and component positions after total knee replacement (TKR) with image-free and image-based robotic-assisted TKR.

Methods

A total of 129 patients (166 knees) suffering from end-stage knee arthritis who underwent TKA operated by robotic-assisted surgery between the years 2018 and mid-2021 were recruited. Radiological outcomes were compared between image-free and image-based robotic-assisted surgical systems.

Results

There were significant differences between the two robotic systems when comparing the mean planned component alignment and the mean measured alignment on radiographs, in which the image-free robotic-assisted system was more varus, whereas the image-based robotic-assisted system was more valgus for both the mean femoral and tibial component coronal alignment (p < 0.001). For tibial component sagittal alignment, the image-based group had a larger deviation from the planned posterior slope (p < 0.001).

Conclusion

Image-free and image-based robotic assisted TKR had differing accuracy in femoral and tibial alignment.

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无图像与基于图像的机器人辅助全膝关节置换术的手术准确性对比
背景 本研究调查了无图像和基于图像的机器人辅助全膝关节置换术(TKR)术后实现正确下肢对位和组件位置的准确性。 方法 共招募了 2018 年至 2021 年中期接受机器人辅助手术的 129 名终末期膝关节炎患者(166 个膝关节)。比较了无图像和基于图像的机器人辅助手术系统的放射学结果。 结果 两种机器人系统在比较计划的平均组件对位和X光片上测量的平均对位时存在明显差异,其中无图像机器人辅助系统的股骨和胫骨组件冠状位的平均对位更偏向于外翻,而基于图像的机器人辅助系统的股骨和胫骨组件冠状位的平均对位更偏向于内翻(p <0.001)。在胫骨组件矢状对位方面,图像辅助组与计划的后斜度偏差更大(p < 0.001)。 结论 无图像和基于图像的机器人辅助 TKR 在股骨和胫骨对位的准确性上存在差异。
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来源期刊
CiteScore
4.50
自引率
12.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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