Minimal Clinically Important Difference in Robotic-Assisted Total Knee Arthroplasty Versus Standard Manual Total Knee Arthroplasty

Shaw, Jiajiu; Lindsay-Rivera, Kevin; Buckley, Patrick J.; Weir, Robb M.; Banka, Trevor R.; Davis, Jason J.

doi:10.1016/j.arth.2021.02.038

Cited by 19 publications

(15 citation statements)

References 27 publications

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“…An increasing number of studies demonstrated that robotic-assisted TKA system can improve surgical outcomes. [22][23][24][25] For example, Sires et al 26 -5 of 11 TKA system in obtaining preoperatively planned coronal alignment of final limb and bone resection. Vaidya et al 27 also demonstrated that robotic-assisted TKA system acquired a better joint line restoration and prosthesis alignment as compared to the conventional TKA.…”

Section: Discussionmentioning

confidence: 99%

Deep learning approach for guiding three‐dimensional computed tomography reconstruction of lower limbs for robotically‐assisted total knee arthroplasty

Zhang

Ding

et al. 2021

Robotics Computer Surgery

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Background: Robotic-assisted total knee arthroplasty (TKA) was performed to promote the accuracy of bone resection and mechanical alignment. Among these TKA system procedures, 3D reconstruction of CT data of lower limbs consumes significant manpower. Artificial intelligence (AI) algorithms applying deep learning has been proved efficient in automated identification and visual processing.Methods: CT data of a total of 200 lower limbs scanning were used for AI-based 3D model construction and CT data of 20 lower limbs scanning were utilised for verification. Results:We showed that the performance of an AI-guided 3D reconstruction of CT data of lower limbs for robotic-assisted TKA was similar to that of the operatorbased approach. The time of 3D lower limb model construction using AI was 4.7 min. AI-based 3D models can be used for surgical planning. Conclusion:AI was used for the first time to guide the 3D reconstruction of CT data of lower limbs for facilitating robotic-assisted TKA. Incorporation of AI in 3D model reconstruction before TKA might reduce the workload of radiologists. K E Y W O R D Sartificial intelligence, HURWA robotic-assisted TKA system, robotically TKA assisted system, 3D CT model | INTRODUCTIONTotal knee arthroplasty (TKA) is an effective procedure for cases with end-stage rheumatoid arthritis or osteoarthritis of the knee. 1 The surgery was carried out in over 370,000 and 700,000 patients annually in China and USA, respectively. 2 Despite the development in implant materials and design, thromboembolic prophylaxis, rehabilitation, computer navigation and patient-specific implants, and the use of prophylactic antibiotics, over 20% of patients reported unsatisfaction following TKA. [3][4][5][6] Robotically assisted TKA was thus developed to promote mechanical alignment, accuracy of bone resection, soft tissue protection, and implant survivorship and implant stability. [7][8][9][10] In this connection, our previous studies showed that a novel HURWA robotic-assisted TKA system (BEIJING HURWA-ROBOT Technology Co. Ltd) could enhance the accuracy of bone resection in terms of resection angles and levels in the sawbone and the sheep models. 11,12 The procedures of robotic-assisted TKA system consists of the following steps: preoperative computed tomography (CT) scanning of lower limbs, three-dimensional (3D) reconstruction of CT data of lower limbs, CT-based planning, surgical planning depending on the 3D CT model, and the act of performing robotic-assisted TKA. Among

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Section: Discussionmentioning

confidence: 99%

Deep learning approach for guiding three‐dimensional computed tomography reconstruction of lower limbs for robotically‐assisted total knee arthroplasty

Zhang

Ding

et al. 2021

Robotics Computer Surgery

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“…29 Sires et al showed that MAKO robotic-assisted TKA system could improve bone resection accuracy. 30 Recently, Shaw et al 31 reported that robotic-assisted TKA showed comparable minimal clinically important difference to manual TKA in a larger cohort. Ltd (Beijing, China) may be an available system for TKA surgery.…”

Section: Discussionmentioning

confidence: 99%

A new robotically assisted system for total knee arthroplasty: A sheep model study

Chen

Zhang

et al. 2021

Robotics Computer Surgery

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Background We investigated the accuracy and safety of a new HURWA robotic‐assisted total knee arthroplasty (TKA) system in a sheep model. Methods Ten male small‐tailed Han sheep were used in this study. Sheep were imaged by computed tomography scan before and after bone resection and the cutting errors between actual bone preparation and preoperative planning of the femur and tibia in three dimensions were measured. Results The overall accuracies after surgery compared with that from preoperative surgical planning of the left and right femurs were 1.93 ± 1.02° and 1.93 ± 1.23°, respectively. Additionally, similarly high overall accuracies for the left and right tibia of 1.26 ± 1.04 and 1.68 ± 0.92°, respectively, were obtained. The gap distances of the distal cut, anterior chamfer, anterior cut, posterior chamfer and posterior cut on the medial side were 0.47 ± 0.35 mm, 0.41 ± 0.37 mm, 0.12 ± 0.26 mm, 0.41 ± 0.44 mm and 0.12 ± 0.23 mm, respectively. No intraoperative complications, such as intraoperative fracture, massive bleeding or death, occurred. Conclusion This new HURWA robotic‐assisted TKA system is an accurate and safe tool for TKA surgery based on the sheep model.

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“…All patients had minimum 90-day followup, and no patients were lost to follow-up. Median LOS was equal for MTKA (33 hours [28,54]) and RTKA (33 hours [30,52]), P ¼ .0118. However, mean LOS for RTKA was less (42.3 hours [23.4]) than MTKA (44.2 [38.2]), P ¼ .0408 (Fig.…”

Section: Study Populationmentioning

confidence: 98%

“…Unfortunately, outcome studies of RTKA are few. Some have reported short-term benefits over MTKA [27e29], while other studies have reported no significant differences [30]. The only long-term outcome studies have shown no difference between RTKA and MTKA, but those were series of first-generation RTKA [31,32], not contemporary platforms.…”

mentioning

confidence: 99%

Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics

Tompkins¹,

Sypher

et al. 2022

The Journal of Arthroplasty

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Minimal Clinically Important Difference in Robotic-Assisted Total Knee Arthroplasty Versus Standard Manual Total Knee Arthroplasty

Cited by 19 publications

References 27 publications

Deep learning approach for guiding three‐dimensional computed tomography reconstruction of lower limbs for robotically‐assisted total knee arthroplasty

Deep learning approach for guiding three‐dimensional computed tomography reconstruction of lower limbs for robotically‐assisted total knee arthroplasty

A new robotically assisted system for total knee arthroplasty: A sheep model study

Robotic Versus Manual Total Knee Arthroplasty in High Volume Surgeons: A Comparison of Cost and Quality Metrics

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