PDF(Pubmed)
Abstract：
UNASSIGNED: The application of robotic-assisted arthroplasty in revision knee scenarios continues to evolve. This study compares the pre- and post-revision implant positions in series of revision total knee arthroplasties (TKA) using a robotic arm system.
UNASSIGNED: Twenty-five consecutive off-label robotic-assisted revision TKA were performed. After virtual revision femoral and tibial components were positioned to achieve \"balanced\" medial and lateral flexion and extension gaps, the existing primary implants (PI) were removed, and bone cuts were executed with the robotic arm system. Preoperative coronal, sagittal, and axial position of the PI was compared to the final planned positions of the robotic revision implants (RRI) for each subject. A repeated measures ANOVA using the absolute difference in millimeters and degrees between the PI and RRI orientation was completed.
UNASSIGNED: Intra-operatively, the virtual gaps were balanced within the planning software followed by successful execution of the plan. There was a statistically significant difference between posterior condylar offset and tibial component positioning for RRI compared to PI. There was no difference between the distal femoral component values between PI and RRI.
UNASSIGNED: The sagittal alignment of the revision implants, specifically the femoral posterior condylar offset and tibial component slope, are statistically significant considerations for a stable revision TKA with off-label use of a robotic-arm system. Other potential benefits may include appropriate implant sizing which can affect the resultant ligamentous tension important for a functional revision TKA. Future research and software iterations will be needed to determine the overall accuracy and utility of robotic-assisted revision TKA.
UNASSIGNED: Twenty-five consecutive off-label robotic-assisted revision TKA were performed. After virtual revision femoral and tibial components were positioned to achieve \"balanced\" medial and lateral flexion and extension gaps, the existing primary implants (PI) were removed, and bone cuts were executed with the robotic arm system. Preoperative coronal, sagittal, and axial position of the PI was compared to the final planned positions of the robotic revision implants (RRI) for each subject. A repeated measures ANOVA using the absolute difference in millimeters and degrees between the PI and RRI orientation was completed.
UNASSIGNED: Intra-operatively, the virtual gaps were balanced within the planning software followed by successful execution of the plan. There was a statistically significant difference between posterior condylar offset and tibial component positioning for RRI compared to PI. There was no difference between the distal femoral component values between PI and RRI.
UNASSIGNED: The sagittal alignment of the revision implants, specifically the femoral posterior condylar offset and tibial component slope, are statistically significant considerations for a stable revision TKA with off-label use of a robotic-arm system. Other potential benefits may include appropriate implant sizing which can affect the resultant ligamentous tension important for a functional revision TKA. Future research and software iterations will be needed to determine the overall accuracy and utility of robotic-assisted revision TKA.
摘要：
■机器人辅助关节成形术在翻修膝关节方案中的应用不断发展。这项研究比较了使用机械臂系统进行的一系列翻修全膝关节置换术（TKA）中翻修前后的植入物位置。
■进行了25次连续的标签外机器人辅助翻修TKA。虚拟翻修后，股骨和胫骨组件定位以实现“平衡”的内侧和外侧屈曲和伸展间隙，现有的主要植入物（PI）被移除，骨切割是用机械臂系统执行的。术前冠状,矢状,将PI的轴向位置与每位受试者的机器人翻修植入物（RRI）的最终计划位置进行比较。使用PI和RRI取向之间的毫米和度数的绝对差完成重复测量ANOVA。
■术中，在计划软件中平衡了虚拟差距，然后成功执行了计划。与PI相比，RRI的后髁偏移和胫骨组件定位之间存在统计学上的显着差异。PI和RRI之间的股骨远端组件值之间没有差异。
■翻修植入物的矢状对齐，特别是股骨后髁偏移和胫骨组件斜率，对于标签外使用机械臂系统的稳定修订TKA，具有统计意义。其他潜在益处可包括适当的植入物尺寸,其可影响对于功能性翻修TKA重要的所得韧带张力。未来的研究和软件迭代将需要确定机器人辅助修订TKA的整体准确性和实用性。
■进行了25次连续的标签外机器人辅助翻修TKA。虚拟翻修后，股骨和胫骨组件定位以实现“平衡”的内侧和外侧屈曲和伸展间隙，现有的主要植入物（PI）被移除，骨切割是用机械臂系统执行的。术前冠状,矢状,将PI的轴向位置与每位受试者的机器人翻修植入物（RRI）的最终计划位置进行比较。使用PI和RRI取向之间的毫米和度数的绝对差完成重复测量ANOVA。
■术中，在计划软件中平衡了虚拟差距，然后成功执行了计划。与PI相比，RRI的后髁偏移和胫骨组件定位之间存在统计学上的显着差异。PI和RRI之间的股骨远端组件值之间没有差异。
■翻修植入物的矢状对齐，特别是股骨后髁偏移和胫骨组件斜率，对于标签外使用机械臂系统的稳定修订TKA，具有统计意义。其他潜在益处可包括适当的植入物尺寸,其可影响对于功能性翻修TKA重要的所得韧带张力。未来的研究和软件迭代将需要确定机器人辅助修订TKA的整体准确性和实用性。
