Top

International Orthopaedics

Published in:

01-11-2017 | Original Paper

Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique

Authors: Yannick Herry, Cécile Batailler, Timothy Lording, Elvire Servien, Philippe Neyret, Sebastien Lustig

Published in: International Orthopaedics | Issue 11/2017

Abstract

Purpose

Joint-line restitution is one objective of unicompartmental knee arthroplasty (UKA). However, the joint line is often lowered when resurfacing femoral implants are used. The aim of this study was to compare the joint-line height in UKA performed by robotic-assisted and conventional techniques.

Methods

This retrospective case–control study compared two matched groups of patients receiving a resurfacing UKA between 2013 and 2016 by either a robotic-assisted (n = 40) or conventional (n = 40) technique. Each group comprised 27 women and 13 menm wuth a mean age of 69 and 68 years, respectively. Indications for surgery were osteoarthritis (n = 35) and condylar osteonecrosis (n = 5). Two validated radiologic measurement methods were used to assess joint-line height.

Results

Forty UKA (23 medial and 17 lateral) were analysed in each group. Restitution of joint-line height was significantly improved in the robotic-assisted group compared than the control group: +1.4 mm ±2.6 vs +4.7 mm ± 2.4 (p < 0.05) as assessed using method 1, and +1.5 mm ±2.3 vs +4.6 mm ±2.5 (p < 0.05) as assessed using method 2.

Conclusions

Restitution of joint-line height in resurfacing UKA can be improved with robotic-assisted surgery. Improvement in clinical outcome measures must be demonstrated with long-term studies.

Kim MS, Koh IJ, Choi YJ, Lee JY, In Y (2016) Differences in patient-reported outcomes between Unicompartmental and Total knee Arthroplasties: a propensity score-matched analysis. J Arthroplast. https://doi.org/10.1016/j.arth.2016.11.034

van der List JP, Chawla H, Zuiderbaan HA, Pearle AD (2016) Patients with isolated lateral osteoarthritis: Unicompartmental or total knee arthroplasty? Knee 23(6):968–974. https://doi.org/10.1016/j.knee.2016.06.007 CrossRefPubMed

Ko YB, Gujarathi MR, Oh KJ (2015) Outcome of Unicompartmental knee Arthroplasty: a systematic review of comparative studies between fixed and mobile bearings focusing on complications. Knee Surg Relat Res 27(3):141–148. https://doi.org/10.5792/ksrr.2015.27.3.141 CrossRefPubMedPubMedCentral

Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for H et al (2012) Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res 98(6 Suppl):S124–S130. https://doi.org/10.1016/j.otsr.2012.07.002 CrossRefPubMed

Barbadoro P, Ensini A, Leardini A, d’Amato M, Feliciangeli A, Timoncini A et al (2014) Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study. Knee Surg Sports Traumatol Arthrosc 22(12):3157–3162. https://doi.org/10.1007/s00167-014-3147-6 CrossRefPubMed

Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplast 20(4 Suppl 2):2–3CrossRef

Lustig S, Lording T, Frank F, Debette C, Servien E, Neyret P (2014) Progression of medial osteoarthritis and long term results of lateral unicompartmental arthroplasty: 10 to 18 year follow-up of 54 consecutive implants. Knee 21(Suppl 1):S26–S32. https://doi.org/10.1016/S0968-0160(14)50006-3 CrossRefPubMed

Small SR, Berend ME, Rogge RD, Archer DB, Kingman AL, Ritter MA (2013) Tibial loading after UKA: evaluation of tibial slope, resection depth, medial shift and component rotation. J Arthroplast 28(9 Suppl):179–183. https://doi.org/10.1016/j.arth.2013.01.004 CrossRef

Pearle AD, O’Loughlin PF, Kendoff DO (2010) Robot-assisted unicompartmental knee arthroplasty. J Arthroplast 25(2):230–237. https://doi.org/10.1016/j.arth.2008.09.024 CrossRef

10.

Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted Unicompartmental knee Arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg Am 98(8):627–635. https://doi.org/10.2106/JBJS.15.00664 CrossRefPubMed

11.

Citak M, Suero EM, Citak M, Dunbar NJ, Branch SH, Conditt MA et al (2013) Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique? Knee 20(4):268–271. https://doi.org/10.1016/j.knee.2012.11.001 CrossRefPubMed

12.

Lonner JH, Smith JR, Picard F, Hamlin B, Rowe PJ, Riches PE (2015) High degree of accuracy of a novel image-free handheld robot for unicondylar knee arthroplasty in a cadaveric study. Clin Orthop Relat Res 473(1):206–212. https://doi.org/10.1007/s11999-014-3764-x CrossRefPubMed

13.

Weber P, Schroder C, Laubender RP, Baur-Melnyk A, von Schulze PC, Jansson V et al (2013) Joint line reconstruction in medial unicompartmental knee arthroplasty: development and validation of a measurement method. Knee Surg Sports Traumatol Arthrosc 21(11):2468–2473. https://doi.org/10.1007/s00167-013-2617-6 CrossRefPubMed

14.

Neyret PDG (1997) Unicompartmental knee replacement: biomaterials and design. In: Deschamps G, Hernigou P (eds) Cartier P EJ. Unicompartmental knee arthroplasty. Exp, Scient, pp 56–60

15.

Hansen DC, Kusuma SK, Palmer RM, Harris KB (2014) Robotic guidance does not improve component position or short-term outcome in medial unicompartmental knee arthroplasty. J Arthroplast 29(9):1784–1789. https://doi.org/10.1016/j.arth.2014.04.012 CrossRef

16.

van der List JP, Chawla H, Joskowicz L, Pearle AD (2016) Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc 24(11):3482–3495. https://doi.org/10.1007/s00167-016-4305-9 CrossRefPubMed

17.

Kwon OR, Kang KT, Son J, Suh DS, Baek C, Koh YG (2017) Importance of joint line preservation in unicompartmental knee arthroplasty: finite element analysis. J Orthop Res 35(2):347–352. https://doi.org/10.1002/jor.23279 CrossRefPubMed

18.

Simpson DJ, Price AJ, Gulati A, Murray DW, Gill HS (2009) Elevated proximal tibial strains following unicompartmental knee replacement--a possible cause of pain. Med Eng Phys 31(7):752–757. https://doi.org/10.1016/j.medengphy.2009.02.004 CrossRefPubMed

19.

Deschamps G, Chol C (2011) Fixed-bearing unicompartmental knee arthroplasty. Patients’ selection and operative technique. Orthop Traumatol Surg Res 97(6):648–661. https://doi.org/10.1016/j.otsr.2011.08.003 CrossRefPubMed

20.

Kuwashima U, Okazaki K, Tashiro Y, Mizu-Uchi H, Hamai S, Okamoto S et al (2015) Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty. Bone Joint Res 4(8):128–133. https://doi.org/10.1302/2046-3758.48.2000416 CrossRefPubMedPubMedCentral

21.

Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165CrossRef

22.

Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA (2006) Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplast 21(6 Suppl 2):108–115. https://doi.org/10.1016/j.arth.2006.04.012 CrossRef

23.

O’Donnell TM, Abouazza O, Neil MJ (2013) Revision of minimal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty. J Arthroplast 28(1):33–39. https://doi.org/10.1016/j.arth.2012.02.031 CrossRef

24.

Ponzio DY, Lonner JH (2016) Robotic technology produces more conservative Tibial resection than conventional techniques in UKA. Am J Orthop (Belle Mead NJ) 45(7):E465–E468

25.

Servien E, Fary C, Lustig S, Demey G, Saffarini M, Chomel S et al (2011) Tibial component rotation assessment using CT scan in medial and lateral unicompartmental knee arthroplasty. Orthop Traumatol Surg Res 97(3):272–275. https://doi.org/10.1016/j.otsr.2010.11.002 CrossRefPubMed

Title: Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique
Authors: Yannick Herry
Cécile Batailler
Timothy Lording
Elvire Servien
Philippe Neyret
Sebastien Lustig
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 11/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3633-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2017

Stability of two versus three peripheral pegs of the glenoid component in modern total shoulder arthroplasty

Papineau technique combined with vacuum-assisted closure for open tibial fractures: clinical outcomes at five years

Incidence and risk factors for symptomatic spinal epidural haematoma following lumbar spinal surgery

How safe and effective is denosumab for bone giant cell tumour?

Two stage revision hip arthroplasty in periprosthetic joint infection. Comparison study: with or without the use of a spacer

Potential risk factors for birth fractures: a case-control study