2021 ISAKOS Biennial Congress ePoster
Patient Specific Alignment is the Key Attribute of Robotically Assisted Surgery. A Comparative Trial with 120 Patients.
Philip Winnock De Grave, MD, Roeselare, West-Vlaanderen BELGIUM
Jonas Kellens, MD, Ardooie BELGIUM
Thomas Tampere, MD, PhD-candidate, Ghent BELGIUM
Hannes Vermue, MD, Ghent BELGIUM
Alexander Ryckaert, MD, Roeselare, West-Vlaanderen BELGIUM
Paul Gunst, MD, Roeselare, West-Vlaanderen BELGIUM
Tamaya Van Criekinge, PhD, Leuven BELGIUM
Thomas Luyckx, MD, PhD, Roeselare, West Vlaanderen BELGIUM
Kurt Claeys, Prof., PhD, Bruges, België/Belgique BELGIUM
AZ Delta, Roeselare, BELGIUM
FDA Status Cleared
Summary
The real added value of robotic assisted surgery is performing patient specific alignment, moreover, patient specific alignment should be the goal.
ePosters will be available shortly before Congress
Abstract
Introduction
Robotic assisted surgery was introduced in total knee arthroplasty (TKA) to improve accuracy of implant positioning with the aim for optimizing clinical outcome. However, the targeted implant position or alignment is debated. Mechanical alignment (MA) is generally seen as the gold-standard, yet patient specific alignment strategies were introduced. Aim of this study was twofold, first to compare clinical outcome of conventional TKA vs. robotically assisted TKA in a mechanical aligned TKA series. Second, to analyze the clinical effect of introducing patient specific alignment (‘inverse kinematic alignment’, iKA) in a robotic assisted TKA cohort.
Materials And Methods
120 patients with end stage osteoarthritis of the knee were enrolled in this study. The first group (n=40) received conventional, mechanical aligned (MA) TKA. The second group (n=40) robotic assisted, mechanical aligned (MA) TKA. The third group (n=40) robotic assisted, inverse kinematic aligned (iKA) TKA. All patients received Triathlon CR TKA with a uniform surgery protocol. The robotic platform used was Mako. The three groups matched for age, gender, BMI and preoperative alignment. Preoperative and 1 year postoperative clinical outcome was documented with Oxford Knee Scores (OKS).
Results
When comparing OKS between the 2 mechanical aligned groups, no significant difference (p=0.066) was calculated between conventional TKA (group 1; 40.3 ± 6.0) and robotically assisted TKA (group 2; 42.2 ± 6.3) at 1 year postop. When comparing OKS between the 2 robotically assisted groups, no significant difference (p=0.069) was calculated between mechanical aligned TKA (group 2; 42.2 ± 6.3) and inverse kinematic aligned TKA (group 3; 44.6 ± 3.5). When comparing conventional mechanical aligned TKA (group 1; 40.3 ± 6.0) with robotically assisted, inverse kinematic aligned TKA (group 3; 44.6 ± 3.5), a significant difference is demonstrated (p<0.01).
Discussion
The results of this study suggest that the introduction of both patient specific alignment and robotically assisted surgery enhance clinical outcome in TKA surgery. Secondly, the real added value of robotic assisted surgery is performing patient specific alignment. Moreover, patient specific alignment should be the goal.