Robotics improves alignment accuracy and reduces early revision rates for UKA in the hands of low-volume UKA surgeons

Savov, Peter; Tuecking, Lars-René; Calließ, Tilman; Ettinger, Max

doi:10.1007/s00402-021-04114-5

Cited by 10 publications

(12 citation statements)

References 37 publications

(67 reference statements)

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“…14 Considering Oxford UKA advantages in rebuilding knee kinematics and decreasing bearing wear, the introduction of this technique will benefit many patients. 15,16 In fact, this technical note is a refinement and complement of the currently popular Oxford UKA tutorial and fully highlights our experience. First, we summarized the five methods to sagittal tibial osteotomy, using two or more to check each other to increase the accuracy of osteotomy.…”

Section: Discussionmentioning

confidence: 78%

“…UKA, a minimally invasive treatment therapy, has become prevalent with the development of technology for local knee arthritis 14 . Considering Oxford UKA advantages in rebuilding knee kinematics and decreasing bearing wear, the introduction of this technique will benefit many patients 15,16 . In fact, this technical note is a refinement and complement of the currently popular Oxford UKA tutorial and fully highlights our experience.…”

Section: Discussionmentioning

confidence: 88%

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How to Perform Better on Oxford UKA? A Technical Note from over 500 Surgical Experiences

Zhang

Bai

Wang

et al. 2023

Orthopaedic Surgery

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Oxford unicompartmental knee arthroplasty (UKA) has been particularly prevalent because the concept of knee preservation is deeply rooted in people's minds. Mobile bearing UKA is a surgical type of UKA with considerable advantages. This note describes some surgical techniques, including patient position, surgical field exposure, selection of the size of the prosthesis, sagittal tibial osteotomy, placement of the femoral prosthesis and gap balance, to assist surgeons with less experience in performing these operations successfully. The techniques described in this note have been used in over 500 Oxford UKA cases, and nearly 95% patients achieved good prosthesis position and satisfactory postoperative outcome. We hope that the empirical summaries from numerous cases will help surgeons to learn Oxford UKA quickly and effectively, driving the spread of the technique and benefiting more patients.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 88%

How to Perform Better on Oxford UKA? A Technical Note from over 500 Surgical Experiences

Zhang

Bai

Wang

et al. 2023

Orthopaedic Surgery

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“…21–23 For UKA specifically, low-volume surgeons have higher revision rates, and robotics reduce revision and improve alignment in the hands of these surgeons. 24,25 Prior literature also suggests that computer navigation improves trochlear rotation in PFA, and smaller studies of robotic-arm–assisted BKA have shown good results. 18,23 In this study, we did not find that improved revision rates after CA partial knee arthroplasty persisted at the 2-year time point.…”

Section: Discussionmentioning

confidence: 99%

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

Malyavko

Cohen

Fuller

et al. 2022

J Am Acad Orthop Surg

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Background:Computer assistance can help surgeons achieve mechanical accurate alignment, but the clinical effect of this technology in different arthroplasty types remains controversial because of conflicting functional outcomes, revision rates, and complication rates. The goal of this study was to compare 90-day medical complications and 1 and 2-year revision surgeries after computer-assisted patellofemoral arthroplasty, unicompartmental knee arthroplasty (CA-UKA), bicompartmental knee arthroplasty (CA-BKA), and total knee arthroplasty (CA-TKA) with non-computer-assisted procedures.Methods:A retrospective cohort analysis was conducted using the Mariner data set of the PearlDiver Patient Records Database from 2010 to 2018. Current Procedural Terminology codes were used to identify patients who underwent patellofemoral arthroplasty, unicompartmental knee arthroplasty, bicompartmental knee arthroplasty, and total knee arthroplasty with or without computer assistance for osteoarthritis. All included patients were followed up for 2 years. Univariate and multivariable analyses were conducted.Results:On multivariable analysis, revision within 1 year was decreased in patients who underwent computer-assisted patellofemoral arthroplasty (odds ratio [OR]: 0.541, P = 0.031), CA-UKA (OR: 0.798, P = 0.019), and computer-assisted bicompartmental knee arthroplasty (OR: 0.186, P = 0.025) compared with the same surgeries without technology assistance. CA-TKA had decreased odds of revision for aseptic loosening at 2 years (OR: 0.789, P < 0.001). CA-UKA and CA-TKA had decreased risk of overall 90-day medical complications (OR: 0.838, P < 0.001; OR: 0.903, P < 0.001, respectively) and major complications (OR: 0.750, P = 0.004; OR: 0.822, P < 0.001, respectively).Discussion:Complication rates and revision surgeries for all arthroplasty types were equivalent or more favorable when computer assistance was used during surgery. Our results quantify some early benefits to using computer assistance in total and partial knee arthroplasties.

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“…coronal and sagittal planes. Assistive technologies, such as robotic-assisted systems, h been developed to improve the accuracy of bone resections and implant positioning UKA [8][9][10] with promising results [6,[11][12][13][14]. Due to the high cost of these devices, h ever, less than 1% of the surgeons in the world have access to a robotic-assisted system UKA.…”

Section: Surgical Techniquementioning

confidence: 99%

“…The extramedullary guides for the tibial resection have been improved over time, but several studies reported a persistent high percentage of outliers [ 5 , 6 , 7 ] with a risk of error in coronal and sagittal planes. Assistive technologies, such as robotic-assisted systems, have been developed to improve the accuracy of bone resections and implant positioning in UKA [ 8 , 9 , 10 ] with promising results [ 6 , 11 , 12 , 13 , 14 ]. Due to the high cost of these devices, however, less than 1% of the surgeons in the world have access to a robotic-assisted system for UKA.…”

Section: Introductionmentioning

confidence: 99%

The Deep-MCL Line: A Reliable Anatomical Landmark to Optimize the Tibial Cut in UKA

Parratte

Daxhelet²,

Argenson

et al. 2023

JPM

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The extramedullary guides for the tibial resection during medial unicompartmental knee arthroplasty (UKA) are inaccurate, with an error risk in coronal and sagittal planes and cut thickness. It was our hypothesis that the use of anatomical landmarks for the tibial cut can help the surgeon to improve accuracy. The technique described in this paper is based on the use of a simple and reproducible anatomical landmark. This landmark is the line of insertion of the fibers of the deep medial collateral ligament (MCL) around the anterior half of the medial tibial plateau called the “Deep MCL insertion line”. The used anatomical landmark determines the orientation (in the coronal and sagittal planes) and the thickness of the tibial cut. This landmark corresponds to the line of insertion of the fibers of the deep MCL around the anterior half of the medial tibial plateau. A consecutive series of patients who underwent primary medial UKA between 2019 and 2021 were retrospectively reviewed. A total of 50 UKA were included. The mean age at the time of surgery was 54.5 ± 6.6 years (44–79). The radiographic measurements showed very good to excellent intra-observer and inter-observer agreements. The limb and implant alignments and the tibial positioning were satisfying, with a low rate of outliers and good restoration of the native anatomy. The landmark of the insertion of deep MCL constitutes a reliable and reproducible reference for the tibial cut axis and thickness during medial UKA, independent of the wear severity.

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Robotics improves alignment accuracy and reduces early revision rates for UKA in the hands of low-volume UKA surgeons

Cited by 10 publications

References 37 publications

How to Perform Better on Oxford UKA? A Technical Note from over 500 Surgical Experiences

How to Perform Better on Oxford UKA? A Technical Note from over 500 Surgical Experiences

Reduced Early Revision Surgery and Medical Complications in Computer-assisted Knee Arthroplasty Compared With Non–computer-assisted Arthroplasty

The Deep-MCL Line: A Reliable Anatomical Landmark to Optimize the Tibial Cut in UKA

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