Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty.

This study was aimed to compare robotic-assisted implantation of a total knee arthroplasty with conventional manual implantation. We controlled, randomized, and reviewed 72 patients for total knee arthroplasty assigned to undergo either conventional manual implantation (excluding navigation-assisted implantation cases) of a Zimmer LPS prosthesis (Zimmer, Warsaw, Ind) (30 patients: group 1) or robotic-assisted implantation of such a prosthesis (32 patients: group 2). The femoral flexion angle (gamma angle) and tibial angle (delta angle) in the lateral x-ray of group 1 were 4.19 +/- 3.28 degrees and 89.7 +/- 1.7 degrees, and those of group 2 were 0.17 +/- 0.65 degrees and 85.5 +/- 0.92 degrees. The major complications were from improper small skin incision during a constraint attempt of minimally invasive surgery and during bulk fixation frame pins insertion. Robotic-assisted technology had definite advantages in terms of preoperative planning, accuracy of the intraoperative procedure, and postoperative follow-up, especially in the femoral flexion angle (gamma angle) and tibial flexion angle (delta angle) in the lateral x-ray, and in the femoral flexion angle (alpha angle) in the anteroposterior x-ray. But a disadvantage was the high complication rate in early stage.

[1]  D A Dennis,et al.  In Vivo Anteroposterior Femorotibial Translation of Total Knee Arthroplasty: A Multicenter Analysis , 1998, Clinical orthopaedics and related research.

[2]  P. Campbell,et al.  Tibial Post Impingement in Posterior-Stabilized Total Knee Arthroplasty , 2002, Clinical orthopaedics and related research.

[3]  F. C. Ewald The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. , 1989, Clinical orthopaedics and related research.

[4]  Michael M Morlock,et al.  Comparison of robotic-assisted and manual implantation of a primary total hip replacement. A prospective study. , 2003, The Journal of bone and joint surgery. American volume.

[5]  W. Bargar,et al.  Primary and Revision Total Hip Replacement Using the Robodoc® System , 1998, Clinical orthopaedics and related research.

[6]  Hideki Yoshikawa,et al.  Comparison of the fit and fill between the Anatomic Hip femoral component and the VerSys Taper femoral component using virtual implantation on the ORTHODOC workstation , 2003, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[7]  N. Sugano Computer-assisted orthopedic surgery , 2003, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[8]  Melinda K Harman,et al.  Mechanism of anterior impingement damage in total knee arthroplasty. , 2002, The Journal of bone and joint surgery. American volume.

[9]  M. Nogler,et al.  Contamination Risk of the Surgical Team Through ROBODOC®’s High-Speed Cutter , 2001, Clinical orthopaedics and related research.

[10]  P. Walker,et al.  Kinematic total knee replacement. , 1984, The Journal of bone and joint surgery. American volume.

[11]  Dominique Scipioni,et al.  Computer-assisted total knee arthroplasty: comparative results in a preliminary series of 72 cases. , 2005, Acta orthopaedica Belgica.

[12]  Hideki Yoshikawa,et al.  Comparison between hand rasping and robotic milling for stem implantation in cementless total hip arthroplasty. , 2006, The Journal of arthroplasty.

[13]  Hideki Yoshikawa,et al.  Clinical accuracy evaluation of femoral canal preparation using the ROBODOC system , 2004, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[14]  Branislav Jaramaz,et al.  Computer-Assisted Orthopaedic Surgery , 1998, Proceedings of the IEEE.

[15]  Mauricio Silva,et al.  Surface Damage on Open Box Posterior-Stabilized Polyethylene Tibial Inserts , 2003, Clinical orthopaedics and related research.

[16]  J. Stiehl,et al.  9 Validation and Metrology in CAOS , 2007 .

[17]  T. Johnson,et al.  Anterior tibial post impingement in a posterior stabilized total knee arthroplasty , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[18]  Pak Lin Chin,et al.  Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. , 2005, The Journal of arthroplasty.

[19]  Branislav Jaramaz,et al.  Computer-Assisted Orthopaedic Surgery for the Hip , 2002 .

[20]  A Leardini,et al.  Alignments and Clinical Results in Conventional and Navigated Total Knee Arthroplasty , 2006, Clinical orthopaedics and related research.

[21]  Russell H. Taylor,et al.  Development of a Surgical Robot for Cementless Total Hip Arthroplasty , 1992, Clinical orthopaedics and related research.

[22]  Eun Kyoo Song,et al.  3D femoral neck anteversion measurements based on the posterior femoral plane in ORTHODOC® system , 2006, Medical & Biological Engineering & Computing.

[23]  S. Ferguson,et al.  Primary stability of a robodoc implanted anatomical stem versus manual implantation. , 2004, Clinical biomechanics.