Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study

Abstract

The alignment of the components of unicompartmental knee arthroplasty (UKA) reportedly influences outcomes and durability. A novel robotic arm technology has been developed with the expectation that it could improve the accuracy of bone preparation in UKA. During the study period, we compared the postoperative radiographic alignment of the tibial component with the preoperatively planned position in 31 knees in 31 consecutive patients undergoing UKA using robotic arm-assisted bone preparation and in 27 consecutive patients who underwent unilateral UKA using conventional manual instrumentation to determine the error of bone preparation and variance with each technique. Radiographically, the root mean square error of the posterior tibial slope was 3.1°w hen using manual techniques compared with 1.9°when using robotic arm assistance for bone preparation. In addition, the variance using manual instruments was 2.6 times greater than the robotically guided procedures. In the coronal plane, the average error was 2.7°± 2.1°more varus of the tibial component relative to the mechanical axis of the tibia using manual instruments compared with 0.2°±

Accuracy of Individualized Custom Tibial Cutting Guides in UKA

“…The jigs used in this study only carefully directed the vertical cut rather than rigidly guide it. But more importantly, the bony anatomy of lateral aspect of the medial condyle may actually guide this cut more than any other structure and thus determine the [19]. Seon et al gave their results for coronal tibial alignment using navigation in UKA [25].…”

Preoperative Mapping in Unicompartmental Knee Arthroplasty Using Computed Tomography Scans Is Associated with Radiation Exposure and Carries High Cost

“…Robotic assistance enhances the accuracy of bone preparation, implant component alignment, and soft tissue balance in unicompartmental knee arthroplasty (UKA) [1][2][3][4][5][6]. Such precision relies on patient-specific preoperative and/or intraoperative mapping, which depending on the system utilized, may require a three-dimensional computed topography (CT) scan of the involved knee and ipsilateral hip and ankle.…”

Comparison of robot-assisted and conventional total knee arthroplasty: A controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment

“…Song et al [28] reported that the mean operation time was 25 minutes longer for robot-assisted TKA compared to the conventional method, but that there was no increase in short-term complication rates. A high complication rate was reported in early cases of robot-assisted surgery, including bone pain related to the implanted fiducials and the fixation jig [19,22,30]. Park and Lee [22] found that complaints about these problems seemed to be lessened after switching to smaller fixation markers and jigs, and no major adverse results have been observed following completion of the learning process.…”