Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2014

01-08-2014 | Knee

Assessment of accuracy of robotically assisted unicompartmental arthroplasty

Authors: Ali Mofidi, Johannes F. Plate, Bo Lu, Michael A. Conditt, Jason E. Lang, Gary G. Poehling, Riyaz H. Jinnah

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2014

Login to get access

Abstract

Purpose

The purpose of this study was to analyse the accuracy of component placement during unicompartmental knee arthroplasty (UKA) using a robotic-assisted system.

Methods

Two hundred and six patients (232 knees) who underwent medial robotic-assisted UKA were retrospectively studied. Femoral and tibial sagittal and coronal alignments were measured in the post-operative radiographs and were compared with the equivalent measurements collected during the intra-operative period by the robotic system. Mismatch between pre-planning and post-operative radiography was assessed against accuracy of the prosthesis insertion.

Results

Robotic-assisted surgery for medial UKA resulted in an average difference of 2.2° ± 1.7° to 3.6° ± 3.3° depending on the component and radiographic view between the intra-operatively planned and post-operative measurements. Mismatch between pre-planning and post-operative radiography (inaccuracy) was related to improper cementing technique of the prosthesis in all measurements (except for tibial sagittal axis) rather than wrong bony cuts performed by the robotic arm.

Conclusion

Robotic-assisted medial UKA results in accurate prosthesis position. Inaccuracy may be attributed to suboptimal cementing technique.

Level of evidence

Comparative retrospective study, Level III.
Literature
1.
Assor M, Aubaniac JM (2006) Influence of rotatory malposition of femoral implant in failure of unicompartimental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot 92(5):473–484PubMedCrossRef
2.
Banks SA (2009) Haptic robotics enable a systems approach to design of a minimally invasive modular knee arthroplasty. Am J Orthop (Belle Mead NJ) 38(2 Suppl):23–27
3.
Berend KR, Lombardi AV Jr, Mallory TH, Adams JB, Groseth KL (2005) Early failure of minimally invasive unicompartmental knee arthroplasty is associated with obesity. Clin Orthop Relat Res 440:60–66PubMedCrossRef
4.
Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16(1):9–18PubMed
5.
Buckup K, Lars-Christoph Linke LC, Hahne V (2007) Minimally invasive implantation and computer navigation for a unicondylar knee system. Orthopedics 30(8 Suppl):66–69PubMed
6.
Chung BJ, Kang YG, Chang CB, Kim SJ (2009) Differences between sagittal and femoral mechanical and distal reference axes should be considered in navigated TKA. Clin Orthop Relat Res 467:2403–2413PubMedCentralPubMedCrossRef
7.
Citak M, Suero EM, Citak M, Dunbar NJ, Branch SH, Conditt MA, Banks SA, Pearle AD (2012) Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique? Knee 20(4):268–271PubMedCrossRef
8.
Cobb J, Henckel J, Gomes P, Harris S, Jakopec M, Rodriguez F, Barrett A, Davies B (2006) Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Joint Surg Br 88(2):188–197PubMedCrossRef
9.
Dalury DF, Dennis DA (2005) Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res 440:77–81PubMedCrossRef
10.
Davies BL, Rodriguez y Baena FM, Barrett AR, Gomes MP, Harris SJ, Jakopec M, Cobb JP (2007) Robotic control in knee joint replacement surgery. Proc Inst Mech Eng H 221(1):71–80PubMedCrossRef
11.
Dunbar NJ, Roche MW, Park BH, Branch SH, Conditt MA, Banks SA (2012) Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty. J Arthroplasty 27(5):803–808PubMedCrossRef
12.
Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplasty 18(Suppl):2–8PubMedCrossRef
13.
Hamilton WG, Collier MB, Tarabee E, McAuley JP, Engh CA Jr, Engh GA (2006) Incidence and reasons for reoperation after minimally invasive unicompartmental knee arthroplasty. J Arthroplasty 21(Suppl):98–107PubMedCrossRef
14.
Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165PubMedCrossRef
15.
Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86:506–511PubMed
16.
Jakopec M, Harris SJ, Rodriguez y Baena F, Gomes P, Cobb J, Davies BL (2001) The first clinical application of a “hands-on” robotic knee surgery system. Comput Aided Surg 6(6):329–339PubMedCrossRef
17.
Jenny JY, Müller PE, Weyer R, John M, Weber P, Ciobanu E, Schmitz A, Bacher T, Neumann W, Jansson V (2006) Navigated minimally invasive unicompartmental knee arthroplasty. Orthopedics 29(10 Suppl):S117–S121PubMed
18.
Jenny JY, Ciobanu E, Boeri C (2007) The rationale for navigated minimally invasive unicompartmental knee replacement. Clin Orthop Relat Res 463:58–62PubMed
19.
Jenny JY (2008) Unicompartmental knee replacement: a comparison of four techniques combining less invasive approach and navigation. Orthopedics 31(10 Suppl 1):2
20.
21.
Keene G, Simpson D, Kalairajah Y (2006) Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Joint Surg Br 88:44–48PubMedCrossRef
22.
Lang JE, Mannava S, Floyd AJ, Goddard MS, Smith BP, Mofidi A, Seyler TM, Jinnah RH (2011) Robotic systems in orthopaedic surgery. J Bone Joint Surg Br 93:1296–1299PubMedCrossRef
23.
Lonner JH (2009) Indications for unicompartmental knee arthroplasty and rationale for robotic arm-assisted technology. Am J Orthop (Belle Mead NJ) 38(2 Suppl):3–6
24.
25.
Lustig S, Paillot JL, Servien E, Henry J, Ait Si Selmi T, Neyret P (2009) Cemented all polyethylene tibial insert unicompartmental knee arthroplasty: a long term follow-up study. Orthop Traumatol Surg Res 95(1):12–21PubMedCrossRef
26.
Minoda Y, Kobayashi A, Iwaki H, Mitsuhiko I, Kadoya Y, Ohashi H, Takaoka K, Nakamura H (2010) The risk of notching the anterior femoral cortex with the use of navigation systems in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 18(6):718–722PubMedCrossRef
27.
Müller PE, Pellengahr C, Witt M, Kircher J, Refior HJ, Jansson V (2004) Influence of minimally invasive surgery on implant positioning and the functional outcome for medial unicompartmental knee arthroplasty. J Arthroplasty 19(3):296–301PubMedCrossRef
28.
O’Donnell T, Neil MJ (2010) The Repicci II® unicondylar knee arthroplasty: 9-year survivorship and function. Clin Orthop Relat Res 468(11):3094–3102PubMedCentralPubMedCrossRef
29.
Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Murray DW (2011) Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg Br 93(2):198–204PubMedCrossRef
30.
Pearle AD, O’Loughlin PF, Kendoff DO (2010) Robot-assisted unicompartmental knee arthroplasty. J Arthroplasty 25(2):230–237PubMedCrossRef
31.
Plate JF, Mofidi A, Mannava S, Smith BP, Lang JE, Poehling GG, Conditt MA, Jinnah RH (2013) Achieving accurate ligament balancing using robotic-assisted unicompartmental knee arthroplasty. Adv Orthop: 837167
32.
Roche M, O’Loughlin PF, Kendoff D, Musahl V, Pearle AD (2009) Robotic arm-assisted unicompartmental knee arthroplasty: preoperative planning and surgical technique. Am J Orthop (Belle Mead NJ) 38(2 Suppl):10–15
33.
Sinha RK (2009) Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. Am J Orthop (Belle Mead NJ) 38(2 Suppl):20–22
34.
Sinha RK, Cutler M (2012) Effect of cement technique on component position during robotic assisted unicompartmental arthroplasty. J Bone Joint Surg Br 94:219
35.
Swienckowski J, Page BJ 2nd (1989) Medial unicompartmental arthroplasty of the knee. Use of the L-cut and comparison with the tibial inset method. Clin Orthop Relat Res 239:161–167PubMed
Metadata
Title
Assessment of accuracy of robotically assisted unicompartmental arthroplasty
Authors
Ali Mofidi
Johannes F. Plate
Bo Lu
Michael A. Conditt
Jason E. Lang
Gary G. Poehling
Riyaz H. Jinnah
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-2969-6

Other articles of this Issue 8/2014

Knee Surgery, Sports Traumatology, Arthroscopy 8/2014 Go to the issue

Knee

Does total knee arthroplasty modify flexion axis of the knee?

Knee

Comparison of stability and kinematics of the natural knee versus a PS TKA with a ‘third condyle’

Erratum

Erratum to: Brake response time returns to the pre-surgical level 6 weeks after unicompartmental knee arthroplasty

Knee

No difference in accuracy between pinless and conventional computer-assisted surgery in total knee arthroplasty

Knee

Better quadriceps recovery after minimally invasive total knee arthroplasty

Knee

The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty