Skip to main content
SpringerLink
Log in

Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Joint-line restitution is one objective of unicompartmental knee arthroplasty (UKA). However, the joint line is often lowered when resurfacing femoral implants are used. The aim of this study was to compare the joint-line height in UKA performed by robotic-assisted and conventional techniques.

Methods

This retrospective case–control study compared two matched groups of patients receiving a resurfacing UKA between 2013 and 2016 by either a robotic-assisted (n = 40) or conventional (n = 40) technique. Each group comprised 27 women and 13 menm wuth a mean age of 69 and 68 years, respectively. Indications for surgery were osteoarthritis (n = 35) and condylar osteonecrosis (n = 5). Two validated radiologic measurement methods were used to assess joint-line height.

Results

Forty UKA (23 medial and 17 lateral) were analysed in each group. Restitution of joint-line height was significantly improved in the robotic-assisted group compared than the control group: +1.4 mm ±2.6 vs +4.7 mm ± 2.4 (p < 0.05) as assessed using method 1, and +1.5 mm ±2.3 vs +4.6 mm ±2.5 (p < 0.05) as assessed using method 2.

Conclusions

Restitution of joint-line height in resurfacing UKA can be improved with robotic-assisted surgery. Improvement in clinical outcome measures must be demonstrated with long-term studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kim MS, Koh IJ, Choi YJ, Lee JY, In Y (2016) Differences in patient-reported outcomes between Unicompartmental and Total knee Arthroplasties: a propensity score-matched analysis. J Arthroplast. https://doi.org/10.1016/j.arth.2016.11.034

  2. van der List JP, Chawla H, Zuiderbaan HA, Pearle AD (2016) Patients with isolated lateral osteoarthritis: Unicompartmental or total knee arthroplasty? Knee 23(6):968–974. https://doi.org/10.1016/j.knee.2016.06.007

    Article  PubMed  Google Scholar 

  3. Ko YB, Gujarathi MR, Oh KJ (2015) Outcome of Unicompartmental knee Arthroplasty: a systematic review of comparative studies between fixed and mobile bearings focusing on complications. Knee Surg Relat Res 27(3):141–148. https://doi.org/10.5792/ksrr.2015.27.3.141

    Article  PubMed  PubMed Central  Google Scholar 

  4. Epinette JA, Brunschweiler B, Mertl P, Mole D, Cazenave A, French Society for H et al (2012) Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res 98(6 Suppl):S124–S130. https://doi.org/10.1016/j.otsr.2012.07.002

    Article  PubMed  Google Scholar 

  5. Barbadoro P, Ensini A, Leardini A, d’Amato M, Feliciangeli A, Timoncini A et al (2014) Tibial component alignment and risk of loosening in unicompartmental knee arthroplasty: a radiographic and radiostereometric study. Knee Surg Sports Traumatol Arthrosc 22(12):3157–3162. https://doi.org/10.1007/s00167-014-3147-6

    Article  CAS  PubMed  Google Scholar 

  6. Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplast 20(4 Suppl 2):2–3

    Article  Google Scholar 

  7. Lustig S, Lording T, Frank F, Debette C, Servien E, Neyret P (2014) Progression of medial osteoarthritis and long term results of lateral unicompartmental arthroplasty: 10 to 18 year follow-up of 54 consecutive implants. Knee 21(Suppl 1):S26–S32. https://doi.org/10.1016/S0968-0160(14)50006-3

    Article  PubMed  Google Scholar 

  8. Small SR, Berend ME, Rogge RD, Archer DB, Kingman AL, Ritter MA (2013) Tibial loading after UKA: evaluation of tibial slope, resection depth, medial shift and component rotation. J Arthroplast 28(9 Suppl):179–183. https://doi.org/10.1016/j.arth.2013.01.004

    Article  Google Scholar 

  9. Pearle AD, O’Loughlin PF, Kendoff DO (2010) Robot-assisted unicompartmental knee arthroplasty. J Arthroplast 25(2):230–237. https://doi.org/10.1016/j.arth.2008.09.024

    Article  Google Scholar 

  10. Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted Unicompartmental knee Arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg Am 98(8):627–635. https://doi.org/10.2106/JBJS.15.00664

    Article  PubMed  Google Scholar 

  11. Citak M, Suero EM, Citak M, Dunbar NJ, Branch SH, Conditt MA et al (2013) Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique? Knee 20(4):268–271. https://doi.org/10.1016/j.knee.2012.11.001

    Article  PubMed  Google Scholar 

  12. Lonner JH, Smith JR, Picard F, Hamlin B, Rowe PJ, Riches PE (2015) High degree of accuracy of a novel image-free handheld robot for unicondylar knee arthroplasty in a cadaveric study. Clin Orthop Relat Res 473(1):206–212. https://doi.org/10.1007/s11999-014-3764-x

    Article  PubMed  Google Scholar 

  13. Weber P, Schroder C, Laubender RP, Baur-Melnyk A, von Schulze PC, Jansson V et al (2013) Joint line reconstruction in medial unicompartmental knee arthroplasty: development and validation of a measurement method. Knee Surg Sports Traumatol Arthrosc 21(11):2468–2473. https://doi.org/10.1007/s00167-013-2617-6

    Article  PubMed  Google Scholar 

  14. Neyret PDG (1997) Unicompartmental knee replacement: biomaterials and design. In: Deschamps G, Hernigou P (eds) Cartier P EJ. Unicompartmental knee arthroplasty. Exp, Scient, pp 56–60

    Google Scholar 

  15. Hansen DC, Kusuma SK, Palmer RM, Harris KB (2014) Robotic guidance does not improve component position or short-term outcome in medial unicompartmental knee arthroplasty. J Arthroplast 29(9):1784–1789. https://doi.org/10.1016/j.arth.2014.04.012

    Article  Google Scholar 

  16. van der List JP, Chawla H, Joskowicz L, Pearle AD (2016) Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc 24(11):3482–3495. https://doi.org/10.1007/s00167-016-4305-9

    Article  PubMed  Google Scholar 

  17. Kwon OR, Kang KT, Son J, Suh DS, Baek C, Koh YG (2017) Importance of joint line preservation in unicompartmental knee arthroplasty: finite element analysis. J Orthop Res 35(2):347–352. https://doi.org/10.1002/jor.23279

    Article  CAS  PubMed  Google Scholar 

  18. Simpson DJ, Price AJ, Gulati A, Murray DW, Gill HS (2009) Elevated proximal tibial strains following unicompartmental knee replacement--a possible cause of pain. Med Eng Phys 31(7):752–757. https://doi.org/10.1016/j.medengphy.2009.02.004

    Article  CAS  PubMed  Google Scholar 

  19. Deschamps G, Chol C (2011) Fixed-bearing unicompartmental knee arthroplasty. Patients’ selection and operative technique. Orthop Traumatol Surg Res 97(6):648–661. https://doi.org/10.1016/j.otsr.2011.08.003

    Article  CAS  PubMed  Google Scholar 

  20. Kuwashima U, Okazaki K, Tashiro Y, Mizu-Uchi H, Hamai S, Okamoto S et al (2015) Correction of coronal alignment correlates with reconstruction of joint height in unicompartmental knee arthroplasty. Bone Joint Res 4(8):128–133. https://doi.org/10.1302/2046-3758.48.2000416

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165

    Article  Google Scholar 

  22. Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA (2006) Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplast 21(6 Suppl 2):108–115. https://doi.org/10.1016/j.arth.2006.04.012

    Article  Google Scholar 

  23. O’Donnell TM, Abouazza O, Neil MJ (2013) Revision of minimal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty. J Arthroplast 28(1):33–39. https://doi.org/10.1016/j.arth.2012.02.031

    Article  Google Scholar 

  24. Ponzio DY, Lonner JH (2016) Robotic technology produces more conservative Tibial resection than conventional techniques in UKA. Am J Orthop (Belle Mead NJ) 45(7):E465–E468

    Google Scholar 

  25. Servien E, Fary C, Lustig S, Demey G, Saffarini M, Chomel S et al (2011) Tibial component rotation assessment using CT scan in medial and lateral unicompartmental knee arthroplasty. Orthop Traumatol Surg Res 97(3):272–275. https://doi.org/10.1016/j.otsr.2010.11.002

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Centre Albert-Trillat, CHU Lyon Croix-Rousse, Hospices Civils de Lyon, 69004, Lyon, France

    Yannick Herry, Cécile Batailler, Elvire Servien, Philippe Neyret & Sebastien Lustig

  2. Melbourne Orthopaedic Group, Melbourne, VIC, Australia

    Timothy Lording

Authors
  1. Yannick Herry
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cécile Batailler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Timothy Lording
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elvire Servien
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Philippe Neyret
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sebastien Lustig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sebastien Lustig.

Ethics declarations

Conflict of interest

YH, CB, and TL: no conflict of interest.

ES: consultant for Smith & Nephew.

PN: consultant for Smith & Nephew, royalties from Tornier-Wright, institutional research support from Tornier-Wright and Amplitude.

SL: consultant for Smith & Nephew, institutional research support to Tornier-Wright and Amplitude.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Herry, Y., Batailler, C., Lording, T. et al. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. International Orthopaedics (SICOT) 41, 2265–2271 (2017). https://doi.org/10.1007/s00264-017-3633-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-017-3633-9

Keywords

Search

Navigation