Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

Pearle, Andrew D.; List, Jelle P. van der; Lee, Lily; Coon, Thomas M.; Borus, Todd; Roche, Martin W.

doi:10.1016/j.knee.2016.12.001

Cited by 109 publications

(74 citation statements)

References 80 publications

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“…32 Oversizing the femur may negatively impact patella tracking and even cause anterior knee pain as a result of patellofemoral concerns. 29,[33][34][35] Prudent femoral component size selection restores the maximal thickness of the posterior femoral condyle, which optimizes the postoperative flexion and also prevents impingement of the posterior cortex of the femur on the tibial tray. 36 Medial tibial overhang may cause soft tissue irritation.…”

Section: Discussionmentioning

confidence: 99%

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

et al. 2018

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Patient dissatisfaction after total knee arthroplasty (TKA) is a concern. Surgical error is a common, avoidable cause of failed TKA. Correct femoral and tibial component sizing improves implant longevity, clinical outcomes, knee balance, and pain scores. We hypothesized that preoperative three-dimensional (3D) templating for robot-assisted TKA (RA-TKA) is more accurate than two-dimensional (2D) digital templating. Prospectively collected data from 31 RA-TKAs were assessed to determine accuracy pertaining to implant sizing and positioning. All cases undergoing RA-TKA undergo preoperative CT-scans as per protocol. Three blinded observers retrospectively templated these knees for TKA using standard radiographs. We compared whether 2D templating was as accurate as CT-guided templating. Postoperative radiographs were then evaluated for sizing and positioning. Intraclass correlation coefficients (ICCs) and the effect of learning curve were assessed. Preoperative femoral component 3D templating and retrospective blinded 2D templating accuracies were 96.6% and 52.9%, respectively (: 17.965; odds ratio [OR]: 24.957, 3.250-191.661; < 0.001). Tibial component 3D and 2D templating accuracies were 93.1% and 28.7%, respectively ( 36.436; OR: 33.480, 7.400-151.481; < 0.001). ICC for the three radiograph observers was 0.920 (95% confidence interval [CI]: 0.652-0.890; < 0.001) for the femur and 0.833 (0.717-0.911; < 0.001) for the tibia, showing excellent agreement. We conclude that preoperative CT-based templating for RA-TKA more accurately predicts the size of implants compared with traditional 2D digital templating. This may improve operating room efficiency and cost containment.

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Section: Discussionmentioning

confidence: 99%

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

et al. 2018

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“…For lateral UKA, valgus alignment of 3–7° was correlated with the best functional outcomes at 2 years postoperatively 85. Pearle et al 86 reported the preliminary results of a multicentre study of 854 patients and found a survivorship of 98.9% and satisfaction rate of 92% at a minimum 2-year follow-up. Comparing these results to other large conventional UKA cohorts may suggest that robotic-assisted surgery could possibly improve survivorship at short-term follow-up 26 58 87…”

Section: Current State Of the Artmentioning

confidence: 96%

“…Initially, robotic systems were introduced to improve precision, accuracy and patient's overall outcome and satisfaction rates 30 79 83 86. Robotic-assisted surgery has the potential to achieve these goals by enhancing the surgeon’ ability to generate reproducible techniques through an individualised surgical approach.…”

Section: Current State Of the Artmentioning

confidence: 99%

Unicompartmental knee arthroplasty: state of the art

et al. 2017

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The popularity of unicompartmental knee arthroplasty (UKA) for the treatment of isolated compartment osteoarthritis of the knee has risen over the past 2 decades. Currently, UKA covers 10% of all knee arthroplasties worldwide. Although indications have been extended, results have proven that patient selection plays a critical role in the success of UKA. From the current perspective, age, body mass index, patellofemoral osteoarthritis, anterior cruciate ligament deficiency and chondrocalcinosis are no longer absolute contraindications for UKA. Motivated by the desire to improve survivorship rates, patient-reported outcomes and reduce complications, there have been many technological advances in the field of UKA over the recent years. The aim of this review was to evaluate the current indications, surgical techniques, modes of failure and survivorship results of UKA, by assessing a thorough review of modern literature. Several studies show that innovations in implant design, fixation methods and surgical techniques have led to good-to-excellent long-term survivorship, functional outcomes and less complications. Until now, resurgence of interest of cementless designs is noted according to large national registries to address problems associated with cementation. The future perspective on the usage of UKA, in particular the cementless design, looks promising. Furthermore, there is a growing interest in robotic-assisted techniques in order to optimise result by controlled soft-tissue balancing and reproduce alignment in UKA. Future advances in robotics, most likely in the field of planning and setup, will be valuable in optimising patient-specific UKA.

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“…They found that accuracy of component positioning was significantly improved with the robotic arm assistance (p < 0.01) [27]. In another study using the robotic arm, Pearle et al followed 909 UKAs for 2.5 years, finding a revision rate of only 1.2%, and in those not revised, they have 92% satisfied or very satisfied [28]. Using the Navio system described above in a cadaveric study, Lonner et al demonstrated less than 2°of error when implanting unicondylar prostheses with the Navio Precision Freehand Sculpting tool (Blue Belt Technologies at the time of study, currently Smith and Nephew, Memphis TN) [29].…”

Section: Unicompartmental Knee Arthroplastymentioning

confidence: 99%

Technology in Arthroplasty: Are We Improving Value?

Waddell

Carroll

Jerabek

2017

Curr Rev Musculoskelet Med

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Recent studies have demonstrated that navigation and robotics in total joint arthroplasty can decrease outliers while improving accuracy in component positioning. While some studies have demonstrated improved patient reported outcomes, not all studies have shown this to be true. Most studies cite increased cost of equipment and longer operating room times as the major downsides of the technologies at present. Long-term studies are just becoming available and are promising, as some studies have shown decreased revision rates when navigation is used. Finally, there are relatively few studies evaluating the direct cost and value of these technologies. Navigation and robotics have been shown to improve component position in total joint arthroplasty, which can improve patient outcomes and implant longevity. These technologies offer a promising future for total joint arthroplasty.

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Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

Cited by 109 publications

References 80 publications

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

Preoperative CT-Based Three-Dimensional Templating in Robot-Assisted Total Knee Arthroplasty More Accurately Predicts Implant Sizes than Two-Dimensional Templating

Unicompartmental knee arthroplasty: state of the art

Technology in Arthroplasty: Are We Improving Value?

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