The Accuracy and Clinical Success of Robotic-Assisted Total Knee Arthroplasty. Issue 3 (October 2021)

• Record Type: Journal Article
• Authors: Nickel, Brian T.; Carroll, Kaitlin M.; Pearle, Andrew D.; Kleeblad, Laura J.; Burger, Joost; Mayman, David J.; Westrich, Geoffrey; Jerabek, Seth A.
• Other Names: Lebl Darren R. guest-editor.; Qureshi Sheeraz A. guest-editor.
• Is Part Of: HSS journal. Volume 17:Issue 3(2021)
• Page Start: 261
• Page End: 266
• Publication Date: 2021-10
• Subjects: robotic-assisted -- total knee arthroplasty -- outcomes -- femoral component alignment -- tibial component alignment; Musculoskeletal system -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; Musculoskeletal System -- surgery -- Periodicals; Orthopedic Procedures -- Periodicals; Orthopédie -- Périodiques; Appareil locomoteur -- Maladies -- Périodiques; Appareil locomoteur -- Maladies -- Patients -- Réadaptation -- Périodiques; 617.47005
• DOI: 10.1177/15563316211026307
• Languages: English
• ISSNs: 1556-3316

Abstract

Background : Robotic-assisted total knee arthroplasty (rTKA) has emerged as a patient-specific customizable tool that enables 3-dimensional preoperative planning, intraoperative adjustment, robotic-assisted bone preparation, and soft-tissue protection. Haptic rTKA may enhance component positioning, but only a few small studies have examined patient satisfaction and clinical outcomes after haptic rTKA. Purpose : In patients who underwent haptic rTKA, we sought to evaluate (1) the discrepancy in alignment between the executed surgical plan and implanted alignment in the coronal and sagittal planes 1 year postoperatively and (2) patient-reported outcomes 2 years postoperatively. Methods : From a prospectively collected database, we reviewed 105 patients who underwent haptic rTKA from August 2016 to May 2017. Two fellowship-trained arthroplasty surgeons independently reviewed hip-to-ankle standing biplanar radiographs to measure overall limb alignment and individual tibial and femoral component alignment relative to the mechanical axis and compared this to the executed surgical plan. Patient-reported outcomes were collected preoperatively and at 2 years postoperatively using the Lower Activity Extremity Score (LEAS), Knee Injury and Osteoarthritis Outcome Score Junior (KOOS Jr.), and Numeric Pain Rating Scale (NPRS). Results : Mean patient age was 62.4 years, and mean body mass index was 30.6 kg/m 2 . Interobserver reliability was significant with a κ of 0.89. Absolute mean deviations in postoperative coronal alignment compared to intraoperative alignment were 0.625° ± 0.70° and 0.45° ± 0.50° for the tibia and femur, respectively. Absolute mean deviations in postoperative tibial sagittal alignment were 0.47° ± 0.76°. Overall mechanical alignment was 0.97° ± 1.79°. Outcomes in LEAS, KOOS Jr., and NPRS changed from 8 to 10, 78 to 88.3, and 8 to 1, respectively. Conclusions : Haptic rTKA demonstrated high reliability and accuracy (less than 1°) of tibial coronal, femoral coronal, and tibial sagittal component alignment postoperatively compared to the surgical plan. Patient-reported outcomes improved, as well. A more rigorous study on long-term outcomes is warranted.