Tags:accuracy, robotic surgery and total knee arthroplasty
Abstract:
Background: Several studies have been performed that compare the accuracy of Robotic-Assisted Total Knee Arthroplasty (RATKA) to conventional instrumentation as well as Computer Assisted Surgery (CAS) to conventional instrumentation, yet there is a lack of studies comparing RATKA to CAS. The purpose of this study is to evaluate the accuracy of a contemporary image free CAS system for TKA in a cadaveric study using the same methodology as used previously to access the accuracy of a RATKA system and Conventional instrumentation. Methods: Four orthopaedic surgeons performed bi-lateral TKA on 18 pelvis-to-toe cadaveric specimens without implantation using the BrainLab Knee3 CAS system. Pre-operative and post-operative computed tomography scans were taken to access the resection accuracy of the CAS system relative to alignment targets recorded intraoperatively. Results: The mean error in femoral coronal angle was 1.08°±0.87° compared to 1.39°±0.95° conventional and 0.63°±0.50° RATKA; the differences between CAS and RATKA were statistically significant. The mean error in the tibial coronal angle was 1.24°±1.13° compared to 1.65°±1.29° conventional and 0.93°±0.72° RATKA. The mean error in femoral flexion was 2.13°±1.87° compared to 3.27°±2.51° conventional and 1.21°±0.90° RATKA; the differences between CAS and manual and CAS and RATKA were statistically significant. The mean errors in the femoral rotation (CAS 1.30°±1.38°, conventional 1.00°±0.70°, RATKA 1.04°±0.81°) and tibial slope (CAS 1.89°±1.28°, conventional 1.63°±1.39°, RATKA 1.62°±1.13°) were similar between the groups. Conclusion: This study showed that for some metrics CAS improves resection accuracy compared to conventional instrumentation and RATKA further improves resection accuracy compared to CAS.
Improvement in Primary Resection Accuracy with Image Free Robotic Assisted Total Knee Arthroplasty