{"title":"Varus/valgus stability in imageless robotic-assisted total knee arthroplasty applying three-dimensional assessment of varus/valgus stress X-rays.","authors":"Hiroki Hijikata, Tomoharu Mochizuki, Keisuku Maeda, Osamu Tanifuji, Go Omori, Noriaki Yamamoto, Hiroyuki Kawashima","doi":"10.3233/BME-230146","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":9109,"journal":{"name":"Bio-medical materials and engineering","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bio-medical materials and engineering","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.3233/BME-230146","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
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.
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.