Improved sizing with image-based robotic-assisted system compared to image-free and conventional techniques in medial unicompartmental knee arthroplasty - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue The Bone & Joint Journal Année : 2021

Improved sizing with image-based robotic-assisted system compared to image-free and conventional techniques in medial unicompartmental knee arthroplasty

Résumé

AIMS: Ideal component sizing may be difficult to achieve in unicompartmental knee arthroplasty (UKA). Anatomical variants, incremental implant size, and a reduced surgical exposure may lead to over- or under-sizing of the components. The purpose of this study was to compare the accuracy of UKA sizing with robotic-assisted techniques versus a conventional surgical technique. METHODS: Three groups of 93 medial UKAs were assessed. The first group was performed by a conventional technique, the second group with an image-free robotic-assisted system (Image-Free group), and the last group with an image-based robotic arm-assisted system, using a preoperative CT scan (Image-Based group). There were no demographic differences between groups. We compared six parameters on postoperative radiographs to assess UKA sizing. Incorrect sizing was defined by an over- or under-sizing greater than 3 mm. RESULTS: There was a higher rate of tibial under-sizing posteriorly in the conventional group compared to robotic-assisted groups (47.3% (n = 44) in conventional group, 29% (n = 27) in Image-Free group, 6.5% (n = 6) in Image-Based group; p < 0.001), as well as a higher rate of femoral under-sizing posteriorly (30.1% (n = 28) in conventional group, 7.5% (n = 7) in Image-Free group, 12.9% (n = 12) in Image-Based group; p < 0.001). The posterior femoral offset was more often increased in the conventional group, especially in comparison to the Image-Based group (43% (n = 40) in conventional group, 30.1% (n = 28) in Image-Free group, 8.6% (n = 8) in Image-Based group; p < 0.001). There was no significant overhang of the femoral or tibial implant in any groups. CONCLUSION: Robotic-assisted surgical techniques for medial UKA decrease the risk of tibial and femoral under-sizing, particularly with an image-based system using a preoperative CT scan. Cite this article: Bone Joint J2021;103-B(4):610-618.
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Dates et versions

hal-03585750 , version 1 (23-02-2022)

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Citer

Cécile Batailler, Maxence Bordes, Timothy Lording, Ana Nigues, Elvire Servien, et al.. Improved sizing with image-based robotic-assisted system compared to image-free and conventional techniques in medial unicompartmental knee arthroplasty. The Bone & Joint Journal, 2021, 103 (4), pp 610-618. ⟨10.1302/0301-620X.103B4.BJJ-2020-1453.R1⟩. ⟨hal-03585750⟩
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