Varus/valgus stability in imageless robotic-assisted total knee arthroplasty applying three-dimensional assessment of varus/valgus stress X-rays.

IF 1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Bio-medical materials and engineering Pub Date : 2024-01-01 DOI:10.3233/BME-230146
Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima
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Abstract

Background: The postoperative varus/valgus stability assessment in stress X-rays has been established as an evaluation index. However, it is performed by the two-dimensional (2D) method rather than the three-dimensional (3D) method.

Objective: This study aimed to identify the precision and reproducibility of measuring varus/valgus stress X-rays three-dimensionally and to examine varus/valgus stability under anesthesia in imageless robotic assisted total knee arthroplasty (rTKA).

Methods: This prospective study analyzed 52 consecutive rTKAs (five males, 67 ± 5.3 years; 47 females, 74 ± 5.9 years). Postoperative varus/valgus stress X-rays in knee extension under anesthesia at manual maximum stress were three-dimensionally assessed by 2D-3D image matching technique using the 3D bone and component models. Varus/valgus angle between components (VV angle) in no stress, valgus stress, varus stress, medial joint opening (MJO), and lateral joint opening (LJO) were evaluated, clarifying this method's precision and reproducibility and valgus/varus stability.

Results: All parameters' precision and reproducibility had <1° mean differences and high intra- and inter-class correlation coefficients. Bland-Altman plots showed no fixed and proportional bias. Non-stress VV angle, valgus VV angle, varus VV angle, MJO, and LJO were 3.6 ± 1.2°, 1.0 ± 1.4°, 7.1 ± 1.9°, 1.5 ± 1.0 mm, and 2.8 ± 2.7 mm, respectively.

Conclusion: This prospective study demonstrated that (1) the three-dimensional measurement method provided sufficient precision and reproducibility, and (2) the rTKAs could achieve good postoperative varus/valgus stability with a small standard deviation.

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应用内翻/外翻应力x射线三维评估在无图像机器人辅助全膝关节置换术中的内翻/外翻稳定性。
背景:已经建立了应力x线术后内翻/外翻稳定性评价作为一种评价指标。然而,它是通过二维(2D)方法而不是三维(3D)方法来执行的。目的:研究机器人辅助全膝关节置换术(rTKA)中三维测量内翻/外翻应力x线的准确性和重复性,并检查麻醉下内翻/外翻的稳定性。方法:本前瞻性研究分析了52例连续rtka患者(男性5例,67±5.3岁;女性47例,74±5.9岁)。采用3D骨和部件模型,采用2D-3D图像匹配技术,对麻醉下人工最大应力下膝关节伸展术后内翻/外翻应力x线进行三维评估。对无应力、外翻应力、内翻应力、内侧关节开口(MJO)和外侧关节开口(LJO)情况下各组件间内翻角(VV角)进行了评价,阐明了该方法的精确性、重复性和外翻稳定性。结论:本前瞻性研究表明:(1)三维测量方法具有足够的精度和重复性;(2)rtka可实现良好的术后内翻/外翻稳定性,标准偏差小。
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来源期刊
Bio-medical materials and engineering
Bio-medical materials and engineering 工程技术-材料科学:生物材料
CiteScore
1.80
自引率
0.00%
发文量
73
审稿时长
6 months
期刊介绍: The aim of Bio-Medical Materials and Engineering is to promote the welfare of humans and to help them keep healthy. This international journal is an interdisciplinary journal that publishes original research papers, review articles and brief notes on materials and engineering for biological and medical systems. Articles in this peer-reviewed journal cover a wide range of topics, including, but not limited to: Engineering as applied to improving diagnosis, therapy, and prevention of disease and injury, and better substitutes for damaged or disabled human organs; Studies of biomaterial interactions with the human body, bio-compatibility, interfacial and interaction problems; Biomechanical behavior under biological and/or medical conditions; Mechanical and biological properties of membrane biomaterials; Cellular and tissue engineering, physiological, biophysical, biochemical bioengineering aspects; Implant failure fields and degradation of implants. Biomimetics engineering and materials including system analysis as supporter for aged people and as rehabilitation; Bioengineering and materials technology as applied to the decontamination against environmental problems; Biosensors, bioreactors, bioprocess instrumentation and control system; Application to food engineering; Standardization problems on biomaterials and related products; Assessment of reliability and safety of biomedical materials and man-machine systems; and Product liability of biomaterials and related products.
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