Abstract：
OBJECTIVE: Robotic-tools have been developed to improve planning, accuracy and outcomes in total knee arthroplasty (TKA). The purpose of this study was to describe and illustrate a novel technique for assessing the patellofemoral (PFJ) in TKA using an imageless robotic platform.
METHODS: A consecutive series of 30 R-TKA were undertaken by a single-surgeon utilising the described technique. A technique to dynamically assess the PFJ intra-operatively, pre and post implantation was developed. A full set of data from 9 cases was then collected and reviewed for analysis. A series of dynamic PFJ tracks collected intra-operatively pre and post implantation are presented. Furthermore, a full assessment of PFJ over and under-stuffing through a 90° arc of flexion is illustrated. Finally, a pre and post centre of rotation for the PFJ was defined and measured.
RESULTS: The described technique was defined over a series of 30 R-TKA using the described robotic platform. Nine cases were analysed to determine what data could be measured using the robotic platform. Intra-operative real-time data allowed a visual assessment of PFJ tracking through a range of motion of 0° to 90° flexion pre and post-implantation. PFJ over and under-stuffing was also assessed intra-operatively through a range of motion of 0° to 90° flexion. Post operative analysis allowed a more detailed study to be performed, including defining a pre and post implantation centre of rotation (COR) for the patella. Defining the COR allowed the definition of a patella plane. Furthermore, patella mediolateral shift in full extension, and end flexion could be measured.
CONCLUSIONS: Intra-operative assessment of the PFJ in TKA is challenging. Robotic tools have been developed to improve measurement, accuracy of delivery and outcomes in TKA. These tools can be adapted in novel ways to assess the PFJ, which may lead to further refinements in TKA techniques.
METHODS: A consecutive series of 30 R-TKA were undertaken by a single-surgeon utilising the described technique. A technique to dynamically assess the PFJ intra-operatively, pre and post implantation was developed. A full set of data from 9 cases was then collected and reviewed for analysis. A series of dynamic PFJ tracks collected intra-operatively pre and post implantation are presented. Furthermore, a full assessment of PFJ over and under-stuffing through a 90° arc of flexion is illustrated. Finally, a pre and post centre of rotation for the PFJ was defined and measured.
RESULTS: The described technique was defined over a series of 30 R-TKA using the described robotic platform. Nine cases were analysed to determine what data could be measured using the robotic platform. Intra-operative real-time data allowed a visual assessment of PFJ tracking through a range of motion of 0° to 90° flexion pre and post-implantation. PFJ over and under-stuffing was also assessed intra-operatively through a range of motion of 0° to 90° flexion. Post operative analysis allowed a more detailed study to be performed, including defining a pre and post implantation centre of rotation (COR) for the patella. Defining the COR allowed the definition of a patella plane. Furthermore, patella mediolateral shift in full extension, and end flexion could be measured.
CONCLUSIONS: Intra-operative assessment of the PFJ in TKA is challenging. Robotic tools have been developed to improve measurement, accuracy of delivery and outcomes in TKA. These tools can be adapted in novel ways to assess the PFJ, which may lead to further refinements in TKA techniques.
摘要：
目标：已经开发了机器人工具来改进计划，全膝关节置换术（TKA）的准确性和结局。这项研究的目的是描述和说明一种使用无图像机器人平台评估TKA中髌股（PFJ）的新技术。
方法：由一名外科医生利用所述技术进行连续的30个R-TKA系列。一种术中动态评估PFJ的技术，植入前后发展。然后收集9例病例的全套数据并进行分析。介绍了植入前后在术中收集的一系列动态PFJ轨迹。此外，说明了通过90°弯曲弧对PFJ上方和下方填充的全面评估。最后,定义并测量了PFJ的前后旋转中心。
结果:使用所描述的机器人平台在一系列R-TKA上定义所描述的技术。分析了9个案例，以确定可以使用机器人平台测量哪些数据。术中实时数据允许通过植入前后0°至90°屈曲的运动范围对PFJ跟踪进行视觉评估。术中还通过0°至90°屈曲的运动范围评估PFJ过度和填充不足。术后分析允许进行更详细的研究，包括限定髌骨的植入前后旋转中心(COR)。定义COR允许髌骨平面的定义。此外，髌骨完全伸展的正外侧移位，和末端弯曲可以测量。
结论：TKA中PFJ的术中评估具有挑战性。已经开发了机器人工具来改善测量，TKA分娩的准确性和结果。这些工具可以以新颖的方式进行调整，以评估PFJ，这可能会导致TKA技术的进一步改进。
方法：由一名外科医生利用所述技术进行连续的30个R-TKA系列。一种术中动态评估PFJ的技术，植入前后发展。然后收集9例病例的全套数据并进行分析。介绍了植入前后在术中收集的一系列动态PFJ轨迹。此外，说明了通过90°弯曲弧对PFJ上方和下方填充的全面评估。最后,定义并测量了PFJ的前后旋转中心。
结果:使用所描述的机器人平台在一系列R-TKA上定义所描述的技术。分析了9个案例，以确定可以使用机器人平台测量哪些数据。术中实时数据允许通过植入前后0°至90°屈曲的运动范围对PFJ跟踪进行视觉评估。术中还通过0°至90°屈曲的运动范围评估PFJ过度和填充不足。术后分析允许进行更详细的研究，包括限定髌骨的植入前后旋转中心(COR)。定义COR允许髌骨平面的定义。此外，髌骨完全伸展的正外侧移位，和末端弯曲可以测量。
结论：TKA中PFJ的术中评估具有挑战性。已经开发了机器人工具来改善测量，TKA分娩的准确性和结果。这些工具可以以新颖的方式进行调整，以评估PFJ，这可能会导致TKA技术的进一步改进。
