Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty : data from a prospective, randomized controlled study

Bell, Stuart W. and Anthony, Iain and Jones, Bryn and MacLean, Angus and Rowe, Philip and Blyth, Mark (2016) Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty : data from a prospective, randomized controlled study. Journal of Bone & Joint Surgery, 98 (8). pp. 627-635. ISSN 0301-620X

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    Abstract

    Higher revision rates have been reported in patients who have undergone unicompartmental knee arthroplasty compared with patients who have undergone total knee arthroplasty, with poor component positioning identified as a factor in implant failure. A robotic-assisted surgical procedure has been proposed as a method of improving the accuracy of component implantation in arthroplasty. The aim of this prospective, randomized, single-blinded, controlled trial was to evaluate the accuracy of component positioning in unicompartmental knee arthroplasty comparing robotic-assisted and conventional implantation techniques. One hundred and thirty-nine patients were randomly assigned to treatment with either a robotic-assisted surgical procedure using the MAKO Robotic Interactive Orthopaedic Arm (RIO) system or a conventional surgical procedure using the Oxford Phase-3 unicompartmental knee replacement with traditional instrumentation. A postoperative computed tomographic scan was performed at three months to assess the accuracy of the axial, coronal, and sagittal component positioning. Data were available for 120 patients, sixty-two who had undergone robotic-assisted unicompartmental knee arthroplasty and fifty-eight who had undergone conventional unicompartmental knee arthroplasty. Intraobserver agreement was good for all measured component parameters. The accuracy of component positioning was improved with the use of the robotic-assisted surgical procedure, with lower root mean square errors and significantly lower median errors in all component parameters (p < 0.01). The proportion of patients with component implantation within 2° of the target position was significantly greater in the group who underwent robotic-assisted unicompartmental knee arthroplasty compared with the group who underwent conventional unicompartmental knee arthroscopy with regard to the femoral component sagittal position (57% compared with 26%, p = 0.0008), femoral component coronal position (70% compared with 28%, p = 0.0001), femoral component axial position (53% compared with 31%, p = 0.0163), tibial component sagittal position (80% compared with 22%, p = 0.0001), and tibial component axial position (48% compared with 19%, p = 0.0009). Robotic-assisted surgical procedures with the use of the MAKO RIO lead to improved accuracy of implant positioning compared with conventional unicompartmental knee arthroplasty surgical techniques.

    Creators(s): Bell, Stuart W., Anthony, Iain, Jones, Bryn, MacLean, Angus, Rowe, Philip ORCID logoORCID: https://orcid.org/0000-0002-4877-8466 and Blyth, Mark;
    Item type:Article
    ID code:56946
    Keywords:knee arthroplasty, limb malalignment, implant positioning, robotic assisted surgical procedures, Bioengineering, Biomedical Engineering
    Subjects:Technology > Engineering (General). Civil engineering (General) > Bioengineering
    Department:Faculty of Engineering > Biomedical Engineering
    Depositing user: Pure Administrator
    Date deposited:12 Jul 2016 12:53
    Last modified:05 Mar 2021 03:21
    URI:https://strathprints.strath.ac.uk/id/eprint/56946
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