Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study
Identifieur interne : 001197 ( Ncbi/Merge ); précédent : 001196; suivant : 001198Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study
Auteurs : Jess H. Lonner [États-Unis] ; Thomas K. John [États-Unis] ; Michael A. Conditt [États-Unis]Source :
- Clinical Orthopaedics and Related Research [ 0009-921X ] ; 2009.
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° when 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° ± 1.8° with robotic technology, and the varus/valgus root mean square error was 3.4° manually compared with 1.8° robotically. Further study will be necessary to determine whether a reduction in alignment errors of these magnitudes will ultimately influence implant function or survival.
Url:
DOI: 10.1007/s11999-009-0977-5
PubMed: 19593669
PubMed Central: 2795844
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John</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Conditt, Michael A" sort="Conditt, Michael A" uniqKey="Conditt M" first="Michael A." last="Conditt">Michael A. Conditt</name><affiliation wicri:level="2"><nlm:aff id="Aff3">Clinical Research, Mako Surgical Corp, Ft Lauderdale, FL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Clinical Research, Mako Surgical Corp, Ft Lauderdale</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19593669</idno><idno type="pmc">2795844</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795844</idno><idno type="RBID">PMC:2795844</idno><idno type="doi">10.1007/s11999-009-0977-5</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000702</idno><idno type="wicri:Area/Pmc/Curation">000702</idno><idno type="wicri:Area/Pmc/Checkpoint">002058</idno><idno type="wicri:Area/Ncbi/Merge">001197</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study</title><author><name sortKey="Lonner, Jess H" sort="Lonner, Jess H" uniqKey="Lonner J" first="Jess H." last="Lonner">Jess H. Lonner</name><affiliation><nlm:aff id="Aff1">Booth Bartolozzi Balderston Orthopaedics, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placename><region type="state">Pennsylvanie</region></placename><wicri:cityArea>Booth Bartolozzi Balderston Orthopaedics, Pennsylvania Hospital, 800 Spruce Street, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="John, Thomas K" sort="John, Thomas K" uniqKey="John T" first="Thomas K." last="John">Thomas K. John</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Conditt, Michael A" sort="Conditt, Michael A" uniqKey="Conditt M" first="Michael A." last="Conditt">Michael A. Conditt</name><affiliation wicri:level="2"><nlm:aff id="Aff3">Clinical Research, Mako Surgical Corp, Ft Lauderdale, FL USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Clinical Research, Mako Surgical Corp, Ft Lauderdale</wicri:cityArea></affiliation></author></analytic><series><title level="j">Clinical Orthopaedics and Related Research</title><idno type="ISSN">0009-921X</idno><idno type="eISSN">1528-1132</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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° when 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° ± 1.8° with robotic technology, and the varus/valgus root mean square error was 3.4° manually compared with 1.8° robotically. Further study will be necessary to determine whether a reduction in alignment errors of these magnitudes will ultimately influence implant function or survival.</p><p><bold>Level of Evidence:</bold> Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Orthop Relat Res</journal-id><journal-title-group><journal-title>Clinical Orthopaedics and Related Research</journal-title></journal-title-group><issn pub-type="ppub">0009-921X</issn><issn pub-type="epub">1528-1132</issn><publisher><publisher-name>Springer-Verlag</publisher-name><publisher-loc>New York</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">19593669</article-id><article-id pub-id-type="pmc">2795844</article-id><article-id pub-id-type="publisher-id">977</article-id><article-id pub-id-type="doi">10.1007/s11999-009-0977-5</article-id><article-categories><subj-group subj-group-type="heading"><subject>Symposium: Papers Presented at the Annual Meetings of the Knee Society</subject></subj-group></article-categories><title-group><article-title>Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Lonner</surname><given-names>Jess H.</given-names></name><degrees>MD</degrees><address><email>lonnerj@pahosp.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>John</surname><given-names>Thomas K.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Conditt</surname><given-names>Michael A.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label>Booth Bartolozzi Balderston Orthopaedics, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA 19107 USA</aff><aff id="Aff2"><label>2</label>Department of Orthopaedic Surgery, Albert Einstein Medical Center, Philadelphia, PA USA</aff><aff id="Aff3"><label>3</label>Clinical Research, Mako Surgical Corp, Ft Lauderdale, FL USA</aff></contrib-group><pub-date pub-type="epub"><day>11</day><month>7</month><year>2009</year></pub-date><pub-date pub-type="ppub"><month>1</month><year>2010</year></pub-date><volume>468</volume><issue>1</issue><fpage>141</fpage><lpage>146</lpage><history><date date-type="received"><day>1</day><month>2</month><year>2009</year></date><date date-type="accepted"><day>25</day><month>6</month><year>2009</year></date></history><permissions><copyright-statement>© The Association of Bone and Joint Surgeons® 2009</copyright-statement></permissions><abstract xml:lang="en"><p>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° when 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° ± 1.8° with robotic technology, and the varus/valgus root mean square error was 3.4° manually compared with 1.8° robotically. Further study will be necessary to determine whether a reduction in alignment errors of these magnitudes will ultimately influence implant function or survival.</p><p><bold>Level of Evidence:</bold> Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.</p></abstract><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Association of Bone and Joint Surgeons® 2010</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li><li>Pennsylvanie</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Lonner, Jess H" sort="Lonner, Jess H" uniqKey="Lonner J" first="Jess H." last="Lonner">Jess H. Lonner</name></noRegion><name sortKey="Conditt, Michael A" sort="Conditt, Michael A" uniqKey="Conditt M" first="Michael A." last="Conditt">Michael A. Conditt</name><name sortKey="John, Thomas K" sort="John, Thomas K" uniqKey="John T" first="Thomas K." last="John">Thomas K. John</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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