Robotic-Assisted Total Knee Arthroplasty in Obese Patients
Background: Robotic-assisted systems have gained popularity in total knee arthroplasty (TKA). The purpose of this study was to evaluate operative characteristics and radiographic outcomes of obese patients undergoing robotic-assisted TKA. Methods: A retrospective review of consecutive cases performe...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344124000050 |
| _version_ | 1797237984865550336 |
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| author | Mary K. Richardson, BS Ryan M. DiGiovanni, MD Brian K. McCrae, Jr., ScB Wesley S. Cooperman, MD John Ludington, PA-C Nathanael D. Heckmann, MD Daniel A. Oakes, MD |
| author_facet | Mary K. Richardson, BS Ryan M. DiGiovanni, MD Brian K. McCrae, Jr., ScB Wesley S. Cooperman, MD John Ludington, PA-C Nathanael D. Heckmann, MD Daniel A. Oakes, MD |
| author_sort | Mary K. Richardson, BS |
| collection | DOAJ |
| description | Background: Robotic-assisted systems have gained popularity in total knee arthroplasty (TKA). The purpose of this study was to evaluate operative characteristics and radiographic outcomes of obese patients undergoing robotic-assisted TKA. Methods: A retrospective review of consecutive cases performed by a single surgeon was performed from January 1, 2016, to January 31, 2022. Adult patients with body mass index ≥35 kg/m2 who underwent primary TKA using a computed tomography–assisted robotic system were compared to patients who underwent primary TKA using conventional instrumentation. Demographics, preoperative and postoperative radiographic measurements, and intraoperative outcomes were compared between cohorts. In total, 119 patients were identified, 60 in the robotic-assisted cohort and 59 in the conventional instrumentation cohort. Results: Age, body mass index, and estimated blood loss were not significantly different between the cohorts. The robotic-assisted cohort experienced longer tourniquet times (93.3 vs 75.5 minutes, P < .001). Preoperative hip-knee-ankle angle (HKA) was similar between the robotic-assisted and conventional cohorts (8.4° ± 4.9° vs 9.3° ± 5.3°, P = .335). Postoperative HKA was 2.0° ± 1.4° in the robotic-assisted group and 3.1° ± 3.23° in the conventional group (P = .040). The proportion of patients with postoperative HKA > 3° of varus or valgus was 9 of 60 (15.0%) in the robotic-assisted cohort compared to 18 of 59 (30.5%) using conventional instrumentation (P = .043). Conclusions: Obese patients treated with robotic-assisted TKA had postoperative alignment closer to neutral and fewer postoperative radiographic outliers than patients treated with conventional instrumentation. The results of this study support use of robotic-assisted technologies in TKA, particularly in obese patients. |
| first_indexed | 2024-03-07T23:22:03Z |
| format | Article |
| id | doaj.art-a65c7d9f88a6499a98ddea3fc730c931 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-24T17:28:26Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-a65c7d9f88a6499a98ddea3fc730c9312024-03-28T06:38:09ZengElsevierArthroplasty Today2352-34412024-04-0126101320Robotic-Assisted Total Knee Arthroplasty in Obese PatientsMary K. Richardson, BS0Ryan M. DiGiovanni, MD1Brian K. McCrae, Jr., ScB2Wesley S. Cooperman, MD3John Ludington, PA-C4Nathanael D. Heckmann, MD5Daniel A. Oakes, MD6Department of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USADepartment of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USAThe Warren Alpert Medical School of Brown University, Providence, RI, USADepartment of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USADepartment of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USADepartment of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USA; Corresponding author. Keck School of Medicine of USC, 1520 San Pablo St, Ste 2000, Los Angeles, CA 90333, USA. Tel.: +1 323 704 6363.Department of Orthopaedic Surgery, School of Medicine of USC, Los Angeles, CA, USABackground: Robotic-assisted systems have gained popularity in total knee arthroplasty (TKA). The purpose of this study was to evaluate operative characteristics and radiographic outcomes of obese patients undergoing robotic-assisted TKA. Methods: A retrospective review of consecutive cases performed by a single surgeon was performed from January 1, 2016, to January 31, 2022. Adult patients with body mass index ≥35 kg/m2 who underwent primary TKA using a computed tomography–assisted robotic system were compared to patients who underwent primary TKA using conventional instrumentation. Demographics, preoperative and postoperative radiographic measurements, and intraoperative outcomes were compared between cohorts. In total, 119 patients were identified, 60 in the robotic-assisted cohort and 59 in the conventional instrumentation cohort. Results: Age, body mass index, and estimated blood loss were not significantly different between the cohorts. The robotic-assisted cohort experienced longer tourniquet times (93.3 vs 75.5 minutes, P < .001). Preoperative hip-knee-ankle angle (HKA) was similar between the robotic-assisted and conventional cohorts (8.4° ± 4.9° vs 9.3° ± 5.3°, P = .335). Postoperative HKA was 2.0° ± 1.4° in the robotic-assisted group and 3.1° ± 3.23° in the conventional group (P = .040). The proportion of patients with postoperative HKA > 3° of varus or valgus was 9 of 60 (15.0%) in the robotic-assisted cohort compared to 18 of 59 (30.5%) using conventional instrumentation (P = .043). Conclusions: Obese patients treated with robotic-assisted TKA had postoperative alignment closer to neutral and fewer postoperative radiographic outliers than patients treated with conventional instrumentation. The results of this study support use of robotic-assisted technologies in TKA, particularly in obese patients.http://www.sciencedirect.com/science/article/pii/S2352344124000050Total knee arthroplastyRobotic-assistedConventionalObesityRadiographic outcomes |
| spellingShingle | Mary K. Richardson, BS Ryan M. DiGiovanni, MD Brian K. McCrae, Jr., ScB Wesley S. Cooperman, MD John Ludington, PA-C Nathanael D. Heckmann, MD Daniel A. Oakes, MD Robotic-Assisted Total Knee Arthroplasty in Obese Patients Arthroplasty Today Total knee arthroplasty Robotic-assisted Conventional Obesity Radiographic outcomes |
| title | Robotic-Assisted Total Knee Arthroplasty in Obese Patients |
| title_full | Robotic-Assisted Total Knee Arthroplasty in Obese Patients |
| title_fullStr | Robotic-Assisted Total Knee Arthroplasty in Obese Patients |
| title_full_unstemmed | Robotic-Assisted Total Knee Arthroplasty in Obese Patients |
| title_short | Robotic-Assisted Total Knee Arthroplasty in Obese Patients |
| title_sort | robotic assisted total knee arthroplasty in obese patients |
| topic | Total knee arthroplasty Robotic-assisted Conventional Obesity Radiographic outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352344124000050 |
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