A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties
Background: The application of robotic-assisted arthroplasty in revision knee scenarios continues to evolve. This study compares the pre- and post-revision implant positions in series of revision total knee arthroplasties (TKA) using a robotic arm system. Methods: Twenty-five consecutive off-label r...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123002157 |
| _version_ | 1827349819228684288 |
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| author | Micah MacAskill, MD Richard Peluso, MD Jonathan Lash, MD Timothy E. Hewett, PhD Matthew Bullock, DO, MPT Alexander Caughran, MD |
| author_facet | Micah MacAskill, MD Richard Peluso, MD Jonathan Lash, MD Timothy E. Hewett, PhD Matthew Bullock, DO, MPT Alexander Caughran, MD |
| author_sort | Micah MacAskill, MD |
| collection | DOAJ |
| description | Background: The application of robotic-assisted arthroplasty in revision knee scenarios continues to evolve. This study compares the pre- and post-revision implant positions in series of revision total knee arthroplasties (TKA) using a robotic arm system. Methods: Twenty-five consecutive off-label robotic-assisted revision TKA were performed. After virtual revision femoral and tibial components were positioned to achieve “balanced” medial and lateral flexion and extension gaps, the existing primary implants (PI) were removed, and bone cuts were executed with the robotic arm system. Preoperative coronal, sagittal, and axial position of the PI was compared to the final planned positions of the robotic revision implants (RRI) for each subject. A repeated measures ANOVA using the absolute difference in millimeters and degrees between the PI and RRI orientation was completed. Results: Intra-operatively, the virtual gaps were balanced within the planning software followed by successful execution of the plan. There was a statistically significant difference between posterior condylar offset and tibial component positioning for RRI compared to PI. There was no difference between the distal femoral component values between PI and RRI. Conclusions: The sagittal alignment of the revision implants, specifically the femoral posterior condylar offset and tibial component slope, are statistically significant considerations for a stable revision TKA with off-label use of a robotic-arm system. Other potential benefits may include appropriate implant sizing which can affect the resultant ligamentous tension important for a functional revision TKA. Future research and software iterations will be needed to determine the overall accuracy and utility of robotic-assisted revision TKA. |
| first_indexed | 2024-03-08T00:48:45Z |
| format | Article |
| id | doaj.art-29536f603d8e4c3188633746dba9b322 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-03-08T00:48:45Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-29536f603d8e4c3188633746dba9b3222024-02-15T05:24:26ZengElsevierArthroplasty Today2352-34412024-02-0125101310A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee ArthroplastiesMicah MacAskill, MD0Richard Peluso, MD1Jonathan Lash, MD2Timothy E. Hewett, PhD3Matthew Bullock, DO, MPT4Alexander Caughran, MD5Corresponding author. Department of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, 1600 Medical Center Drive, Suite G500, Huntington, WV 25705, USA. Tel.: +1 304 691 1262.; Department of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USADepartment of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USADepartment of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USADepartment of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USADepartment of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USADepartment of Orthopaedics, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USABackground: The application of robotic-assisted arthroplasty in revision knee scenarios continues to evolve. This study compares the pre- and post-revision implant positions in series of revision total knee arthroplasties (TKA) using a robotic arm system. Methods: Twenty-five consecutive off-label robotic-assisted revision TKA were performed. After virtual revision femoral and tibial components were positioned to achieve “balanced” medial and lateral flexion and extension gaps, the existing primary implants (PI) were removed, and bone cuts were executed with the robotic arm system. Preoperative coronal, sagittal, and axial position of the PI was compared to the final planned positions of the robotic revision implants (RRI) for each subject. A repeated measures ANOVA using the absolute difference in millimeters and degrees between the PI and RRI orientation was completed. Results: Intra-operatively, the virtual gaps were balanced within the planning software followed by successful execution of the plan. There was a statistically significant difference between posterior condylar offset and tibial component positioning for RRI compared to PI. There was no difference between the distal femoral component values between PI and RRI. Conclusions: The sagittal alignment of the revision implants, specifically the femoral posterior condylar offset and tibial component slope, are statistically significant considerations for a stable revision TKA with off-label use of a robotic-arm system. Other potential benefits may include appropriate implant sizing which can affect the resultant ligamentous tension important for a functional revision TKA. Future research and software iterations will be needed to determine the overall accuracy and utility of robotic-assisted revision TKA.http://www.sciencedirect.com/science/article/pii/S2352344123002157Robotic assistedRevisionKnee replacementSagittal alignmentCondylar offset |
| spellingShingle | Micah MacAskill, MD Richard Peluso, MD Jonathan Lash, MD Timothy E. Hewett, PhD Matthew Bullock, DO, MPT Alexander Caughran, MD A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties Arthroplasty Today Robotic assisted Revision Knee replacement Sagittal alignment Condylar offset |
| title | A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties |
| title_full | A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties |
| title_fullStr | A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties |
| title_full_unstemmed | A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties |
| title_short | A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties |
| title_sort | three dimensional comparison of pre and post component position in a series of off label robotic assisted revision total knee arthroplasties |
| topic | Robotic assisted Revision Knee replacement Sagittal alignment Condylar offset |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123002157 |
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