2017 ISAKOS Biennial Congress ePoster #1203

 

Robot-Assisted Minimal Invasive Total Knee Arthroplasty

Sang-Jin Park, MD, Gwangju KOREA, REPUBLIC OF
Jae Yoon Chung, MD, PhD, Gwang ju KOREA, REPUBLIC OF

Segyero hospital, Gwang ju, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

MIS Robot-assisted TKA could be performed without any complication and achieve satisfactory clinical and radiological results. MIS Robot-assisted TKA has the potential to synchronize the benefit of Robotics and MIS surgery in TKA.

Abstract

Introduction

Robot-assisted total knee arthroplasty (TKA) has obvious advantage for achieving accurate implant positions and postoperative mechanical alignment. However, big skin incision (more than 12.5cm) was necessary for safety reason. And minimal invasive TKA had a risk of malposition of the implant and outlier of the alignment. The purpose of this study is to evaluate the clinical and radiologic result of Robotic-assisted TKA using minimal invasive surgery (MIS) technique.

Materials And Methods

: 34 osteoarthritic knees having MIS Robotic assisted TKA were involved in this study (MIS Robotics group) and the skin was incised less than 10cm in all cases. 50 knees having conventional Robot-assisted TKA were enrolled for control group (conventional Robotics group) and the mean length of skin incision was 13.4cm. There was no difference in age, sex, BMI, preoperative range of motion and deformity between two groups. For MIS Robotic TKA, first, knee flexion angle was reduced to 70 degree during fixating the knee to the robotic arms. Secondly, the order of cutting was changed to make a more room for work: distal and anterior femur cutting, proximal tibia cutting, in sequence, posterior femur cutting using additional rooms created by pervious cutting. Thirdly, cutting pathway was changed to anteromedial direction. And mobile window was used for soft tissue retraction.
HSS score and range of motion were used for clinical evaluation preoperatively and postoperatively. Total blood loss, hidden blood loss, transfusion amount, and changes in Hg/Hct were evaluated and compaired at postoperative 3 day. A hip-knee-ankle axis in full weight bearing standing radiography was measured for axis evaluation and implant positions were measured in standard knee radiography.

Results

Intraoperative technical failure and complications related to robot did not occurred in MIS Robotics group. In 31 cases (91.2%), the postoperative mechanical axis was within 3 degrees with a mean of -0.8±1.2. There was no difference in implant position and postoperative limb alignment in two groups (P> 0.05). The mean operation time was 83±14 min and was mean 9 min less compared to control group. Clinically both groups had satisfactory results. There was no difference in postoperative knee range of motion and HSS scores (P> 0.05).

There was no difference in mean drop of Hg/Hct at postoperative 3 day. The mean total blood loss, hidden loss and transfusion amount was less in MIS robotic group, however there were no statistical significance.

Conclusion

MIS Robot-assisted TKA could be performed without any complication and achieve satisfactory clinical and radiological results. MIS Robot-assisted TKA has the potential to synchronize the benefit of Robotics and MIS surgery in TKA.