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Liu P, Lu FF, Liu GJ, Mu XH, Sun YQ, Zhang QD, Wang WG, Guo WS. Robotic-assisted unicompartmental knee arthroplasty: a review. ARTHROPLASTY 2021; 3:15. [PMID: 35236463 PMCID: PMC8796542 DOI: 10.1186/s42836-021-00071-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 01/21/2021] [Indexed: 11/10/2022] Open
Abstract
Purpose Presented here is an up-to-date review concerning robotic-assisted unicompartmental knee arthroplasty (rUKA), including its rationale, operative system, pros and cons. Methods We did a systematic research in electronic databases, including PubMed, Cochrane Library, Web of Science, and Embase up to March 30, 2020 to retrieve literature pertaining to rUKA. The search strategies “(robotic* AND knee arthroplasty OR knee replacement)” and “(knee arthroplasty OR knee replacement NOT total)” were used. Studies describing rUKA and clinical trials, dry bone or cadaveric researches regarding technologies, positioning, alignment, function, or survivorship of implants were included in this review. All retrieved studies were first browsed for eligibility on the basis of title and abstract, and the selected studies were further evaluated by reading full text for final inclusion. Results Robotic-assisted technology has been found to increase the accuracy of bone preparation and implant placement, reduce technical variability and outliers, and enhance reproduction of limb alignment. Additionally, early clinical outcomes were excellent, but mid-term follow-up showed no superiority in component survivorship. The potential drawbacks of the robotic-assisted technology include relatively-low time- and cost-effectiveness, development of some rUKA-related complications, and lack of support by high-quality literature. Conclusion This review shows that rUKA can decrease the number of outliers concerning the optimal implant positioning and limb alignment. However, due to absence of extensive studies on clinical outcomes and long-term results, it remains unclear whether the improved component positioning translates to better clinical outcomes or long-term survivorship of the implant. Nevertheless, since an accurate implant position is presumably beneficial, robotic-assisted technology is worth recommendation in UKA.
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Affiliation(s)
- Pei Liu
- Department of Adult Joint Reconstruction, Henan Luoyang Orthopaedic Hospital (Henan Provincial Orthopaedic Hospital), Yongping Road, Zhengdong New District, Zhengzhou, China
| | - Fei-Fan Lu
- China-Japan Friendship School of Clinical Medicine, Peking University, Yinghuadong Road, Chaoyang District, Beijing, China
| | - Guo-Jie Liu
- Department of Adult Joint Reconstruction, Henan Luoyang Orthopaedic Hospital (Henan Provincial Orthopaedic Hospital), Yongping Road, Zhengdong New District, Zhengzhou, China
| | - Xiao-Hong Mu
- Department Orthopedics 4, Beijing University of Chinese Medicine, Dongzhimen Hospital, Beijing, China
| | - Yong-Qiang Sun
- Department of Adult Joint Reconstruction, Henan Luoyang Orthopaedic Hospital (Henan Provincial Orthopaedic Hospital), Yongping Road, Zhengdong New District, Zhengzhou, China
| | - Qi-Dong Zhang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, No. 2, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Wei-Guo Wang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, No. 2, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Wan-Shou Guo
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, No. 2, Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
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Batailler C, Swan J, Sappey Marinier E, Servien E, Lustig S. New Technologies in Knee Arthroplasty: Current Concepts. J Clin Med 2020; 10:jcm10010047. [PMID: 33375702 PMCID: PMC7795103 DOI: 10.3390/jcm10010047] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
Total knee arthroplasty (TKA) is an effective treatment for severe osteoarthritis. Despite good survival rates, up to 20% of TKA patients remain dissatisfied. Recently, promising new technologies have been developed in knee arthroplasty, and could improve the functional outcomes. The aim of this paper was to present some new technologies in TKA, their current concepts, their advantages, and limitations. The patient-specific instrumentations can allow an improvement of implant positioning and limb alignment, but no difference is found for functional outcomes. The customized implants are conceived to reproduce the native knee anatomy and to reproduce its biomechanics. The sensors have to aim to give objective data on ligaments balancing during TKA. Few studies are published on the results at mid-term of these two devices currently. The accelerometers are smart tools developed to improve the TKA alignment. Their benefits remain yet controversial. The robotic-assisted systems allow an accurate and reproducible bone preparation due to a robotic interface, with a 3D surgical planning, based on preoperative 3D imaging or not. This promising system, nevertheless, has some limits. The new technologies in TKA are very attractive and have constantly evolved. Nevertheless, some limitations persist and could be improved by artificial intelligence and predictive modeling.
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Affiliation(s)
- Cécile Batailler
- Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, 69004 Lyon, France; (J.S.); (E.S.M.); (E.S.); (S.L.)
- Service de Chirurgie Orthopédique, Université de Lyon, Université Claude Bernard Lyon 1, LBMC UMR_T9406, 69003 Lyon, France
- Cécile BATAILLER, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
- Correspondence:
| | - John Swan
- Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, 69004 Lyon, France; (J.S.); (E.S.M.); (E.S.); (S.L.)
| | - Elliot Sappey Marinier
- Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, 69004 Lyon, France; (J.S.); (E.S.M.); (E.S.); (S.L.)
- Service de Chirurgie Orthopédique, Université de Lyon, Université Claude Bernard Lyon 1, LBMC UMR_T9406, 69003 Lyon, France
| | - Elvire Servien
- Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, 69004 Lyon, France; (J.S.); (E.S.M.); (E.S.); (S.L.)
- EA 7424, Interuniversity Laboratory of Human Movement Science, Université Lyon 1, 69100 Villeurbanne, France
| | - Sébastien Lustig
- Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, 69004 Lyon, France; (J.S.); (E.S.M.); (E.S.); (S.L.)
- Service de Chirurgie Orthopédique, Université de Lyon, Université Claude Bernard Lyon 1, LBMC UMR_T9406, 69003 Lyon, France
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吴 东, 杨 敏, 曹 正, 孔 祥, 王 毅, 郭 人, 柴 伟. [Research progress in unicompartmental knee arthroplasty]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:145-150. [PMID: 32030942 PMCID: PMC8171978 DOI: 10.7507/1002-1892.201906085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 11/24/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To summarize the clinical application and research progress in unicompartmental knee arthroplasty (UKA). METHODS The literature related to UKA in recent years was reviewed and the emerging indications, implant options, comparisons between other surgical techniques, and recent advances were summarized. RESULTS Clinical studies show that UKA has many advantages, such as less trauma, faster recovery, and fewer postoperative complications. At present, the operative indication has been expanded. The body mass index more than 25 kg/m 2, less than 60 years old, patellofemoral arthritis, and anterior cruciate ligament dysfunction are no longer considered as contraindications. The prosthesis type in UKA should be selected according to the patient's condition. In recent years, the robot-assisted UKA can effectively improve the effectiveness, improve patient satisfaction, and reduce postoperative complications. CONCLUSION With the development of surgical techniques, designs of prosthesis, and the robotic technology, UKA would be further applicated. As more long-term data on UKA become available, it will further guide clinicians in counseling patients on whether UKA should be performed.
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Affiliation(s)
- 东 吴
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
| | - 敏之 杨
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
- 南开大学医学院(天津 300071)Medicine School of Nankai University, Tianjin, 300071, P.R.China
| | - 正 曹
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
- 南开大学医学院(天津 300071)Medicine School of Nankai University, Tianjin, 300071, P.R.China
| | - 祥朋 孔
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
| | - 毅 王
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
| | - 人文 郭
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
| | - 伟 柴
- 中国人民解放军总医院第一医学中心骨科(北京 100853)Department of Orthopedics, the First Medical Center, Chinese PLA General Hospital, Beijing, 100853, P.R.China
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Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2019; 27:1232-1240. [PMID: 30066017 DOI: 10.1007/s00167-018-5081-5] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this case-control study was to compare implant position and revision rate for UKA, performed with either a robotic-assisted system or with conventional technique. METHODS Eighty UKA (57 medial, 23 lateral) were performed with robotic assistance (BlueBelt Navio system) between 2013 and 2017. These patients were matched with 80 patients undergoing UKA using the same prosthesis, implanted using conventional technique. The sagittal and coronal component position was assessed on postoperative radiographs. The revision rate was reported at last follow-up. RESULTS The mean follow-up was 19.7 months ± 9 for the robotic-assisted group, and 24.2 months ± 16 for the control group. The rate of postoperative limb alignment outliers (± 2°) was significantly higher in the control group than in the robotic-assisted group for both lateral UKA (26% in robotic group versus 61% in control group; p = 0.018) and medial UKA (16% versus 32%, resp.; p = 0.038). The coronal and sagittal tibial baseplate position had significantly less outliers (± 3°) in the robotic-assisted group, than in the control group. Revision rates were: 5% (n = 4/80) for robotic assisted UKA and 9% (n = 7/80) for conventional UKA (n.s.). The reasons for revision were different between groups, with 86% of revisions in the control group occurring in association with component malposition or limb malalignment, compared with none in the robotic-assisted group. CONCLUSION Robotic-assisted UKA has a lower rate of postoperative limb alignment outliers, as well as a lower revision rate, compared to conventional technique. The accuracy of implant positioning is improved by this robotic-assisted system. LEVEL OF EVIDENCE Level of evidence III. Retrospective case-control study CLINICAL RELEVANCE: This is the first paper comparing implant position, clinical outcome, and revision rate for UKA performed using the Navio robotic system with a control group.
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Affiliation(s)
- Cécile Batailler
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France.
| | - Nathan White
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
| | | | - Philippe Neyret
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
| | - Elvire Servien
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
| | - Sébastien Lustig
- Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France
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