Comparison of the in vivo kinematics between robotic-assisted Bi-cruciate retaining and Bi-cruciate stabilised total knee arthroplasty

Ashley Ying-Ying Wong, Michael Tim-Yun Ong, Tsz Lung Choi, Gloria Yan-Ting Lam, Xin He, Mingqian Yu, Ben Chi-Yin Choi, Daniel T. P. Fong, Patrick Shu-Hang Yung
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Abstract

Background

Up to 20% of patients remain unsatisfied after total knee arthroplasty (TKA), prompting the development of new implants. Bi-Cruciate Retaining (BCR) TKA preserves both the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), with the ACL beneficial for its proprioceptive qualities. The Bi-Cruciate Stabilised (BCS) TKA substitutes the ACL and PCL with a unique dual cam-post mechanism. Robotics improve accuracy and facilitate technically demanding TKA.

Methods

This was a retrospective case-control study recruited from two centres. Measured outcomes included kinematic analysis, proprioception, and functional outcomes.

Results

There was a significantly larger maximum flexion angle and range of flexion to extension in sit-to-stand and stairs in BCR when compared to BCS. Further analysis revealed more similarities between BCR and normal native knees. Proprioception and functional scores did not have any statistical difference.

Conclusion

BCR TKA demonstrated better knee flexion in weight-bearing active range of motion and showed similarities with normal knee kinematics.

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机器人辅助双髋关节固定和双髋关节稳定全膝关节置换术的活体运动学比较
背景 多达 20% 的患者在接受全膝关节置换术 (TKA) 后仍不满意,这促使人们开发新的植入物。双十字韧带保留(BCR)TKA 同时保留了前十字韧带(ACL)和后十字韧带(PCL),其中前十字韧带因其本体感觉特性而受益。双十字韧带稳定型(BCS)TKA 采用独特的双凸轮支柱机制替代前十字韧带和后十字韧带。机器人技术提高了准确性,并为技术要求较高的 TKA 提供了便利。 方法 这是一项回顾性病例对照研究,研究人员来自两个中心。测量结果包括运动学分析、本体感觉和功能结果。 结果 与BCS相比,BCR在坐立和上楼梯时的最大屈曲角度和屈伸范围明显更大。进一步的分析表明,BCR与正常原生膝关节之间有更多相似之处。运动感觉和功能评分没有任何统计学差异。 结论 BCR TKA 在负重主动运动范围内显示出更好的膝关节屈曲度,并显示出与正常膝关节运动学的相似性。
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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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