PDF(Pubmed)
Abstract：
OBJECTIVE: Robot-assisted total knee arthroplasty (TKA) was developed to improve the precision and accuracy of implant placement in conventional TKA. However, the angular differences between referenced axes in robot-assisted TKA and conventional TKA remain unclear. The aim of this study was to investigate the angular differences in sagittal alignment between robot-assisted TKA and conventional TKA for both the femur and the tibia and to discuss their clinical implications.
METHODS: We conducted a retrospective analysis of data from 100 patients (97 patients) who underwent computed tomography (CT) for Mako TKA. We measured the angle between the robot femoral axis (RFA) and conventional femoral axis (CFA) in the sagittal plane and the angle between the robot tibial axis (RTA) and the conventional tibial axis (CTA). Angles were compared between the sexes. Correlation analysis was conducted between the angles and height.
RESULTS: In the sagittal plane, the mean RFA-CFA angle was 2.2° ± 1.6°, and the mean RTA-CTA angle was 2.3° ± 1.6°. There were no significant differences between the two angles among males and females (p > 0.05). There was a correlation between the RFA-CFA angle and RTA-CTA angle (p < 0.001, r = 0.33), and there was a correlation between height and the combination of the RFA-CFA angle and RTA-CTA angle (p = 0.03, r = 0.22).
CONCLUSIONS: There are angular differences between the axes referenced by robot-assisted TKA and those referenced by conventional TKA, which may be influenced by patient height. Correctly understanding these differences is crucial when evaluating the implant position and surgical outcomes after robot-assisted TKA. Furthermore, caution should be taken when assessing the flexion-extension angle of the knee since the angles displayed in the Mako system are different from the angles measured with intramedullary anatomical axes. After all, sagittal alignment principles differ between robot-assisted and conventional TKA; however, further studies are required to determine which principle is more appropriate or to modify these principles.
METHODS: We conducted a retrospective analysis of data from 100 patients (97 patients) who underwent computed tomography (CT) for Mako TKA. We measured the angle between the robot femoral axis (RFA) and conventional femoral axis (CFA) in the sagittal plane and the angle between the robot tibial axis (RTA) and the conventional tibial axis (CTA). Angles were compared between the sexes. Correlation analysis was conducted between the angles and height.
RESULTS: In the sagittal plane, the mean RFA-CFA angle was 2.2° ± 1.6°, and the mean RTA-CTA angle was 2.3° ± 1.6°. There were no significant differences between the two angles among males and females (p > 0.05). There was a correlation between the RFA-CFA angle and RTA-CTA angle (p < 0.001, r = 0.33), and there was a correlation between height and the combination of the RFA-CFA angle and RTA-CTA angle (p = 0.03, r = 0.22).
CONCLUSIONS: There are angular differences between the axes referenced by robot-assisted TKA and those referenced by conventional TKA, which may be influenced by patient height. Correctly understanding these differences is crucial when evaluating the implant position and surgical outcomes after robot-assisted TKA. Furthermore, caution should be taken when assessing the flexion-extension angle of the knee since the angles displayed in the Mako system are different from the angles measured with intramedullary anatomical axes. After all, sagittal alignment principles differ between robot-assisted and conventional TKA; however, further studies are required to determine which principle is more appropriate or to modify these principles.
摘要：
目的：开发了机器人辅助的全膝关节置换术（TKA），以提高常规TKA中植入物放置的精度和准确性。然而,机器人辅助TKA和传统TKA中参考轴之间的角度差异尚不清楚。这项研究的目的是研究机器人辅助TKA和常规TKA在股骨和胫骨的矢状对齐角度差异，并讨论其临床意义。
方法：我们对100例因MakoTKA接受计算机断层扫描（CT）的患者（97例）的数据进行了回顾性分析。我们测量了矢状平面中机器人股骨轴（RFA）与常规股骨轴（CFA）之间的角度以及机器人胫骨轴（RTA）与常规胫骨轴（CTA）之间的角度。性别之间的角度进行了比较。在角度和高度之间进行相关性分析。
结果：在矢状面，平均RFA-CFA角度为2.2°±1.6°，平均RTA-CTA角为2.3°±1.6°。男性和女性之间的两个角度之间没有显着差异（p>0.05）。RFA-CFA角与RTA-CTA角之间存在相关性(p<0.001,r=0.33),身高与RFA-CFA角度和RTA-CTA角度的组合之间存在相关性（p=0.03，r=0.22）。
结论：机器人辅助TKA参考的轴与常规TKA参考的轴之间存在角度差异，这可能会受到患者身高的影响。在评估机器人辅助TKA后的植入物位置和手术结果时，正确理解这些差异至关重要。此外，由于Mako系统中显示的角度与髓内解剖轴测得的角度不同，因此在评估膝关节的屈伸角度时应格外小心。毕竟,机器人辅助TKA和传统TKA的矢状对齐原理有所不同；然而，需要进一步的研究来确定哪个原则更合适或修改这些原则。
方法：我们对100例因MakoTKA接受计算机断层扫描（CT）的患者（97例）的数据进行了回顾性分析。我们测量了矢状平面中机器人股骨轴（RFA）与常规股骨轴（CFA）之间的角度以及机器人胫骨轴（RTA）与常规胫骨轴（CTA）之间的角度。性别之间的角度进行了比较。在角度和高度之间进行相关性分析。
结果：在矢状面，平均RFA-CFA角度为2.2°±1.6°，平均RTA-CTA角为2.3°±1.6°。男性和女性之间的两个角度之间没有显着差异（p>0.05）。RFA-CFA角与RTA-CTA角之间存在相关性(p<0.001,r=0.33),身高与RFA-CFA角度和RTA-CTA角度的组合之间存在相关性（p=0.03，r=0.22）。
结论：机器人辅助TKA参考的轴与常规TKA参考的轴之间存在角度差异，这可能会受到患者身高的影响。在评估机器人辅助TKA后的植入物位置和手术结果时，正确理解这些差异至关重要。此外，由于Mako系统中显示的角度与髓内解剖轴测得的角度不同，因此在评估膝关节的屈伸角度时应格外小心。毕竟,机器人辅助TKA和传统TKA的矢状对齐原理有所不同；然而，需要进一步的研究来确定哪个原则更合适或修改这些原则。
