Preliminary outcomes of kinematically aligned robot-assisted total knee arthroplasty with patient-specific cartilage thickness measurement

Turan, Kayhan; Çamurcu, Yalkın; Kezer, Murat; Uysal, Yunus; Kızılay, Yusuf Onur; Temiz, Abdulaziz

doi:10.1007/s11701-022-01503-9

Cited by 5 publications

(7 citation statements)

References 32 publications

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“…Details of the study selection and inclusion process are illustrated in Figure 1 (PRISMA Flowchart). Eleven studies completely fulfilled the inclusion criteria [ 1 , 3 , 7 , 8 , 17 , 18 , 24 , 25 , 31 , 32 , 33 ], including one RCT [ 3 ], five nonrandomized control trials/quasi‐experiments [ 3 , 8 , 24 , 25 , 31 ], three case series [ 7 , 32 , 33 ], and two cohort studies [ 1 , 18 ]. Three studies compared satisfaction outcomes after TKA between MA TKA and KA TKA [ 18 , 24 , 25 ], three reported satisfaction outcomes after KA TKA only [ 31 , 32 ] and five reported satisfaction outcomes after MA TKA only [ 1 , 3 , 6 , 7 , 17 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

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No difference in postoperative patient satisfaction rates between mechanical and kinematic alignment total knee arthroplasty: A systematic review

Khan,

Leica,

Sava

et al. 2024

J. exp. orthop.

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PurposeThe purpose of this systematic review was to compare patient satisfaction patient‐reported outcomes (PROMs) levels after mechanically aligned (MA) and kinematically aligned (KA) total knee arthroplasty (TKA).MethodsA systematic literature search following PRISMA guidelines was conducted on PubMed, Embase, Medline and Scopus to identify potentially relevant articles for this review, published from the beginning of March 2013 until the end of October 2023. Only articles reporting satisfaction after KA TKA, MA TKA or both were included, which use valid and reliable tools for the evaluation and reporting of satisfaction after TKA. Title, authors, year of publication, study design, level of evidence, follow‐up period, patients' demographic data, sample size, type of satisfaction score, postoperative satisfaction score, postoperative alignment, statistical significance, as well as other variables, were extracted for analysis. An Agency for Healthcare Research and Quality's (AHRQ) design‐specific scale was used for assessing randomized control trials (RCTs). The nonrandomized control trials were evaluated by using the Joanna Briggs Institute's (JBI) Critical Appraisal Tool. The Newcastle‐Ottawa Scale (NOS) was also used to assess cohort studies, while case series were evaluated using the NIH Quality Assessment Tool for Case Series Studies.ResultsThe initial search identified 316 studies, of which 178 were considered for screening. Eleven studies completely fulfilled the inclusion criteria, including one RCT, five nonrandomized control trials/quasi‐experiments, three case series, and two cohort studies. The total number of patients recruited for MA TKA was 1740. Conversely, 497 patients were enrolled for KA TKA. Five studies used the visual analogue scale (VAS) for assessing postoperative patient satisfaction, four used the Knee Society Score (KSS) 2011 version and two Likert‐based types of scores. Overall, the highest mean satisfaction score of KSS 2011 was 31.5 ± 6.6 in the MA group, and 29.8 ± 80 in the KA group in four studies. All of them showed high postoperative patient satisfaction rates for both MA and KA TKA, but with no statistically significant difference between them (p > 0.05).ConclusionBoth mechanically aligned total knee arthroplasty, as well as kinematically aligned total knee arthroplasty led to high rates of postoperative patient satisfaction, with no statistically significant differences between them.Level of EvidenceLevel III, systematic review.

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Section: Resultsmentioning

confidence: 99%

“…Four studies used 2011 KSS for assessing satisfaction [ 24 , 25 , 31 , 33 ], while five studies have used VAS [ 1 , 3 , 7 , 8 , 32 ]. In all the included studies, the method of satisfaction assessment was clearly mentioned in the methodology section.…”

Section: Resultsmentioning

confidence: 99%

No difference in postoperative patient satisfaction rates between mechanical and kinematic alignment total knee arthroplasty: A systematic review

Khan,

Leica,

Sava

et al. 2024

J. exp. orthop.

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“…Measurement of HKA in FLRs is still the gold standard to plan, perform, and evaluate the alignment of TKA [18,24]. However, it has previously been shown that various factors inluence radiographic measurements of coronal limb alignment.…”

Section: Discussionmentioning

confidence: 99%

Postoperative full leg radiographs exhibit less residual coronal varus deformity compared to intraoperative measurements in robotic arm-assisted total knee arthroplasty with the MAKO™ system

Glowalla

Langer

Lenze

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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Purpose Robotic arm-assisted total knee arthroplasty (raTKA), currently a major trend in knee arthroplasty, aims to improve the accuracy of implant positioning and limb alignment. However, it is unclear whether and to what extent manual radiographic and navigation measurements with the MAKO™ system correlate. Nonetheless, a high agreement would be crucial to reliably achieve the desired limb alignment. Methods Thirty-six consecutive patients with osteoarthritis and a slight-to-moderate varus deformity undergoing raTKA were prospectively included in this study. Prior to surgery and at follow-up, a full leg radiograph (FLR) under weight-bearing conditions was performed. In addition, a computed tomography (CT) scan was conducted for preoperative planning. The hip–knee–ankle angle (HKA), mechanical lateral distal femur angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) and joint line convergence angle (JLCA) were measured in the preoperative and follow-up FLR as well as in the CT scout (without weight-bearing) by three independent raters. Furthermore, the HKA was intraoperatively assessed with the MAKO™ system before and after raTKA. Results Significantly higher HKA values were identified for intraoperative deformity assessment using the MAKO system compared to the preoperative FLR and CT scouts (p = 0.006; p = 0.05). Intraoperative assessment of the HKA with final implants showed a mean residual varus deformity of 3.2° ± 1.9°, whereas a significantly lower residual varus deformity of 1.4° ± 1.9° was identified in the postoperative FLR (p < 0.001). The mMPTA was significantly higher in the preoperative FLR than in the CT scouts (p < 0.001). Intraoperatively, the mMPTA was adjusted to a mean of 87.5° ± 0.9° with final implants, while significantly higher values were measured in postoperative FLRs (p < 0.001). Concerning the mLDFA, no significant differences could be identified. Conclusion The clinical importance of this study lies in the finding that there is a difference between residual varus deformity measured intraoperatively with the MAKO™ system and those measured in postoperative FLRs. This has implications for preoperative planning as well as intraoperative fine-tuning of the implant position during raTKA to avoid overcorrection of knees with slight-to-moderate varus osteoarthritis. Level of evidence Level IV.

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“…For example, perhaps more access to kinetic analyses and their implications can be studied to better understand mobility issues, along with surface electromyography to detail motor synergies and motor unit signaling attributes and records of joint pain frequency that align with radiographic measures and disease severity [38][39][40]. It is also anticipated that the accurate evaluation of cartilage cell status and organization can specifically increase the objectivity of imaging evaluations as well as highlighting possible regeneration opportunities and how any alterations align with the clinical presentation of hip osteoarthritis [32,41,42].…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence and Its Potential Application in Advancing Hip Osteoarthritis Care

Marks¹

2023

JOSR

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Background: Hip joint osteoarthritis remains an incurable disabling health condition. Aim: To examine what trends exist in the realm of Artificial Intelligence [AI] applications to hip osteoarthritis. Methods: An in-depth literature review focusing on hip osteoarthritis and selected artificial intelligence association’s themes was conducted. Results: Artificial intelligence is being widely studied and applied in the realms of hip osteoarthritis diagnoses and surgical factors and approaches, but less so in the clinical, and deterministic spheres. Conclusion: Future expanded research efforts that integrate the features of the whole joint and person-environment factors and their association with favorable and unfavorable hip osteoarthritis outcomes are needed and are likely to prove promising and save immense human and service costs. Keywords: Arthroplasty; Artificial Intelligence; Deep Learning, Diagnosis; Hip Osteoarthritis; Machine Learning; Outcomes; Pathology; Prevention; Surgery

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Preliminary outcomes of kinematically aligned robot-assisted total knee arthroplasty with patient-specific cartilage thickness measurement

Cited by 5 publications

References 32 publications

No difference in postoperative patient satisfaction rates between mechanical and kinematic alignment total knee arthroplasty: A systematic review

No difference in postoperative patient satisfaction rates between mechanical and kinematic alignment total knee arthroplasty: A systematic review

Postoperative full leg radiographs exhibit less residual coronal varus deformity compared to intraoperative measurements in robotic arm-assisted total knee arthroplasty with the MAKO™ system

Artificial Intelligence and Its Potential Application in Advancing Hip Osteoarthritis Care

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