ISAKOS: 2023 Congress in Boston, MA USA

2023 ISAKOS Biennial Congress Paper

 

Image-free Robotic-Assisted Total Knee Arthroplasty Improves the Rotational Mismatch Between Femoral and Tibial Components, but Not Forgotten Joint Score 12 using three-dimensional computed tomography Measurements: A Consecutive Case Control Study

Ayakane Yamamoto, MD, Fuefuki JAPAN
Takao Kaneko, MD, PhD,, Fuefuki JAPAN
Kazutaka Takada, MD, Tokyo JAPAN
Shu Yoshizawa, MD, Tokyo JAPAN
Hiroyasu Ikegami, MD, PhD, Prof., Tokyo JAPAN
Ichinomiya Onsen Hot Hospital, Adult Reconstruction Center, Fuefuki, JAPAN

FDA Status Cleared

Summary

In robotic-assisted (RA) TKA, the accuracy of femoral component rotation placement was improved and there were fewer cases of the rotational missmatch, although, forgotten joint score-12 was lower in RA-TKA compared to conventional TKA.

Abstract

Background

The primary aim of this study was to compare the postoperative short-term patient reported outcome measurements (PROMs) and component accuracy in conventional jig-based total knee arthroplasty (Conv-TKA) versus a robotic-assisted TKA (RA-TKA) using three-dimensional computed tomography (3DCT) measurements.

Methods

This retrospective, consecutive case control trial included 83 patients with varus osteoarthritis of the knee undergoing Conv-TKA versus RA-TKA using bi-cruciate stabilized TKA (BCS) (Journey?BCS; Smith & Nephew. Inc. Memphis, TN, USA). PROMs (2011 Knee Society Score (KSS), forgotten joint score-12 (FJS-12), patella score) were compared in patients who had been postoperative for at least 1 year and less than 2 years. Hip-knee-ankle (HKA) angle, component alignment (1989 knee society (KS); a, ß, ?, d angle), rotational angles of the femoral and tibial component and rotational mismatch between the two groups were compared using 3DCT measurements.

Results

There were no statistically significant differences in the preoperative factors between the groups: age at surgery, BMI, preoperative range of motion (ROM), HKA angle, and 1989 Knee society knee and function score. Postoperative PROMs (pain, patient satisfaction, patient expectation, advanced activities in 2011 KSS) and patella score were not significantly different between the groups, but FJS-12 was significantly improved in Conv-TKA than in RA-TKA (p< 0.01). Although there were no significant differences in postoperative HKA angle, a, ß, ?, d angles, and tibial rotation angle, the absolute value of femoral rotational angle and rotational mismatch were significantly smaller in RA-TKA group than in Conv-TKA group (p< 0.01, p< 0.01).

Conclusions

RA-TKA did not improve FJS-12 compared to Conv-TKA, but improved accuracy of femoral component rotational position and rotational mismatch.

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