Robotic assistance improves success of cementless component fixation in one total knee arthroplasty system

IF 1.6 4区 医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-10-12 DOI:10.1016/j.knee.2024.09.012
Catelyn A. Woelfle, Jeffrey A. Geller, Alexander L. Neuwirth, Nana O. Sarpong, Roshan P. Shah, H. John Cooper
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Abstract

Introduction

New cementless implant designs in total knee arthroplasty (TKA) have begun to shift the longstanding practice of cemented fixation. With aseptic loosening a leading cause for revision of cementless implants, initial osteointegration is critical for component survivorship. Robotic-assisted TKA (RA-TKA) has shown promising results in recent literature at improving component accuracy. The current study aims to evaluate if robotic assistance affects the success of cementless fixation in primary TKA.

Methods

445 cementless primary TKA components from one manufacturer implanted by five surgeons between June 2018 and October 2022 were retrospectively reviewed. Those with minimum one-year follow-up were analyzed. Femoral and tibial components were reviewed separately and grouped based on whether manual or RA-TKA from the same manufacturer was performed. Fisher’s exact test was used to analyze if aseptic loosening rates were different between the two techniques.

Results

373 (82%) cementless components from a single knee system were included. 146 femoral and 103 tibial components were implanted using RA-TKA, while 63 femoral and 61 tibial components were implanted manually. At a mean follow-up of 18 months (range, 12 to 51 months), successful fixation was achieved in 96.2% of all components. No femoral components from either group were revised due to aseptic loosening. Four manually implanted vs. no robotically assisted tibial components were revised due to aseptic loosening (6.6% vs 0.0%; P = 0.038).

Conclusion

The performance of modern cementless femoral components was excellent with or without robotic assistance, however RA-TKA improved the survivorship of the same system’s cementless tibial component.
Level of Evidence: Level III.
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机器人辅助提高了一种全膝关节成形术系统中无骨水泥组件固定的成功率
导言:全膝关节置换术(TKA)中的新型无骨水泥植入物设计已开始改变长期以来的骨水泥固定做法。无菌性松动是导致无骨水泥植入物翻修的主要原因,因此最初的骨结合对于植入物的存活至关重要。最近的文献显示,机器人辅助 TKA(RA-TKA)在提高组件准确性方面取得了可喜的成果。本研究旨在评估机器人辅助是否会影响原发性 TKA 中无骨水泥固定的成功率。方法回顾性审查了 2018 年 6 月至 2022 年 10 月间由五位外科医生植入的一家制造商生产的 445 个无骨水泥原发性 TKA 组件。对随访至少一年的组件进行了分析。分别回顾了股骨和胫骨组件,并根据是否进行了同一制造商的手动或 RA-TKA 进行了分组。采用 Fisher 精确检验分析两种技术的无菌性松动率是否存在差异。146个股骨和103个胫骨组件采用RA-TKA植入,63个股骨和61个胫骨组件采用人工植入。在平均 18 个月(12 至 51 个月)的随访中,96.2% 的组件成功固定。两组中均没有股骨组件因无菌性松动而进行翻修。结论无论是否有机器人辅助,现代无骨水泥股骨组件的性能都很好,但RA-TKA提高了同一系统的无骨水泥胫骨组件的存活率:证据等级:三级
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来源期刊
Knee
Knee 医学-外科
CiteScore
3.80
自引率
5.30%
发文量
171
审稿时长
6 months
期刊介绍: The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.
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