Sagittal accuracy and functional impact of tibial slope in imageless robotic-assisted Total Knee Arthroplasty.

IF 2.6 3区 医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2025-06-01 Epub Date: 2025-03-17 DOI:10.1007/s00264-025-06472-w
Erwan Eggermont, Raphael Janssens, Maarten Ulrix, Jean-François Fils, Jacques Hernigou, Johnatan Everaert, Bruno Baillon
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Abstract

Purpose: Study of the sagittal accuracy of the 'Robotic Surgical Assistant' (ROSA®), compared to conventional surgery, regarding the application of the tibial slope (TS). Study of the impact of TS on the range of motion (ROM) and patient-reported outcome measures (PROMS).

Methods: Inclusion of patients who underwent primary Total Knee Arthroplasty (TKA) between 1/1/2021 and 15/4/2024. Divided into robotic-assisted TKA (RA-TKA) and manual TKA (M-TKA). Measurement of pre- and post-operative TS, using the posterior tibial cortex, on profile knee X-rays. 3° TS applied arbitrarily for both groups. ROM was measured pre-operatively and at three, six and 12 months post-operatively. Patient satisfaction assessed via Knee Injury and Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score (OKS).

Results: 266 patients were included in the study. The M-TKA (110) had a post-operative TS of 3.11° (± 2.12°). 81.21% were within 2° of the target and 92.87% within 3°. The RA-TKA (82) had a post-operative TS of -0.11° ± (1.93°). 36.83% were within 2° of the target and 56.63% within 3°. RA-TKA had a KOOS of 64.43 ± 12.87 and OKS of 33.05 ± 6.01. M-TKA had a KOOS of 64.18 ± 13.11 and OKS of 32.31 ± 5.97. Maximum flexion at 12 months was 118.74° ± 8.19° for M-TKA and 121.88° ± 7.43° for RA-TKA (p = 0.002).

Conclusion: The application of TS using ROSA® was less precise than the conventional method in achieving post-operative TS values as measured on X-rays. However, there were no clinical differences in ROM or PROMS.

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机器人辅助全膝关节置换术中矢状面准确性和胫骨斜度对功能的影响。
目的:研究“机器人手术助手”(ROSA®)在胫骨斜坡(TS)应用方面的矢状面准确性,与传统手术相比。TS对活动范围(ROM)和患者报告结果测量(PROMS)影响的研究。方法:纳入2021年1月1日至2024年4月15日期间接受原发性全膝关节置换术(TKA)的患者。分为机器人辅助TKA (RA-TKA)和手动TKA (M-TKA)。测量术前和术后的TS,使用胫骨后皮质,在膝关节x线上。3°TS任意应用于两组。分别于术前、术后3个月、6个月和12个月测量ROM。通过膝关节损伤和骨关节炎结局评分(oos)和牛津膝关节评分(OKS)评估患者满意度。结果:266例患者纳入研究。M-TKA(110)术后TS为3.11°(±2.12°)。81.21%在目标2°范围内,92.87%在目标3°范围内。RA-TKA(82)术后TS为-0.11°±(1.93°)。36.83%在目标2°范围内,56.63%在目标3°范围内。RA-TKA的KOOS为64.43±12.87,OKS为33.05±6.01。M-TKA的KOOS为64.18±13.11,OKS为32.31±5.97。M-TKA组12个月最大屈曲度为118.74°±8.19°,RA-TKA组为121.88°±7.43°(p = 0.002)。结论:在获得术后x线测量的TS值方面,使用ROSA®的TS应用不如传统方法精确。然而,在ROM或PROMS方面没有临床差异。
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来源期刊
International Orthopaedics
International Orthopaedics 医学-整形外科
CiteScore
5.50
自引率
7.40%
发文量
360
审稿时长
1 months
期刊介绍: International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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