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Robot-Assisted Total Knee Arthroplasty

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Essentials of Cemented Knee Arthroplasty
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Abstract

Robotic technology is being used with increasing frequency in total knee arthroplasty (TKA). Current semiautonomous and autonomous robotic systems have shown improvements in accuracy and reduction in alignment errors compared to conventional techniques. While some recent studies are beginning to show an impact on function, pain, and costs, the majority of available studies have not shown a link between accuracy and quantified soft tissue balance achieved with robotic assistance and a measurable influence on function or durability. Nonetheless, even with an equivalence of outcomes, robotic-assisted TKA will potentially redefine the emerging paradigm of TKA if costs can be controlled, efficiencies improved, and ergonomics enhanced.

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References

  • Abdel MP, Ollivier M, Parratte S, Trousdale RT, Berry DJ, Pagnano MW (2018) Effect of postoperative mechanical axis alignment on survival and functional outcomes of modern total knee arthroplasties with cement: a concise follow-up at 20 years. J Bone Joint Surg Am 100(6):472–478

    Article  PubMed  Google Scholar 

  • Antonios JK, Kang HP, Robertson D, Oakes DA, Lieberman JR, Heckmann ND (2020) Population-based survivorship of computer-navigated versus conventional total knee arthroplasty. J Am Acad Orthop Surg 28(20):857–864

    Article  PubMed  Google Scholar 

  • Asimov I (1950) In: Robot I (ed) The Isaac Asimov collection. Doubleday, New York, p 40

    Google Scholar 

  • Barbash Glied SA (2010) New technology and health care costs – the case of robotic-assisted surgery. N Engl J Med 363:701–704

    Article  PubMed  Google Scholar 

  • Barbash GI, Friedman B, Glied SA, Steiner CA (2014) Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure. Ann Surg 259:1–6

    Article  PubMed  Google Scholar 

  • Bargar WL (2007) Robots in orthopaedic surgery. Clin Orthop Relat Res 463:31–36

    Article  PubMed  Google Scholar 

  • Battenberg AK, Netravali NA, Lonner JH (2019) A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship. J Robot Surg 14(1):55–60

    Article  PubMed  PubMed Central  Google Scholar 

  • BenMessaoud C, Kharrazi H, MacDorman KF (2011) Facilitators and barriers to adopting robotic-assisted surgery: contextualizing the unified theory of acceptance and use of technology. PLoS One 6:e16395

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Blute ML, Prestipino AL (2014) Factors associated with adoption of robotic surgical technology in US hospitals and relationship to radical prostatectomy procedure volume. Ann Surg 259:7–9

    Article  PubMed  Google Scholar 

  • Sherman WF, Wu VJ. Robotic Surgery in Total Joint Arthroplasty: A Survey of the AAHKS Membership to Understand the Utilization, Motivations, and Perceptions of Total Joint Surgeons. J Arthroplasty 2020:S0883540320307373. https://doi.org/10.1016/j.arth.2020.06.072

  • Boylan M, Suchman K, Vigdorchik J, Slover J, Bosco J (2018) Technology-assisted hip and knee arthroplasties: an analysis of utilization trends. J Arthroplast 33(4):1019–1023

    Article  Google Scholar 

  • Buckingham RA, Buckingham RO (1995) Robots in operating theatres. BMJ 311(7018):1479–1482

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Casper M, Mitra R, Khare R, Jaramaz B, Hamlin B, McGinley B, Mayman D, Headrick J, Urish K, Gittins M, Incavo S, Neginhal V (2018) Accuracy assessment of a novel image-free handheld robot for total knee arthroplasty in a cadaveric study. Comput Assist Surg (Abingdon) 23(1):14–20

    Article  Google Scholar 

  • Chun YS, Kim KL, Cho YJ, Kim YH, Yoo MC, Rhyu KH (2011) Causes and patterns of aborting a robot-assisted arthroplasty. J Arthroplast 26(4):621–625

    Article  Google Scholar 

  • Cool CL, Jacofsky DJ, Seeger KA, Sodhi N, Mont MA (2019) A 90-day episode-of-care cost analysis of robotic-arm assisted total knee arthroplasty. J Comp Eff Res 8(5):327–336

    Article  PubMed  Google Scholar 

  • Davey SM (2011) Surgeon opinion on new technologies in orthopaedic surgery. J Med Eng Technol 35:139–148

    Article  CAS  PubMed  Google Scholar 

  • de Steiger RN, Liu Y, Graves SE (2015) Computer navigation for total knee arthroplasty reduces revision rate for patients less than sixty-five years of age. J Bone Joint Surg Am 97(8):635–642

    Article  PubMed  Google Scholar 

  • Dunbar NJ, Roche MW, Park BH, Branch SH, Conditt MA, Banks SA (2012) Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty. J Arthroplast 27:803–808

    Article  Google Scholar 

  • Gilmour A, MacLean AD, Rowe PJ, Banger MS, Donnelly I, Jones BG, Blyth MJG (2018) Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial. J Arthroplast 33:S109–S115

    Article  Google Scholar 

  • Hampp EL, Chughtai M, Scholl LY, Sodhi N, Bhowmik-Stoker M, Jacofsky DJ, Mont MA (2019a) Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. J Knee Surg 32(3):239–250

    Article  PubMed  Google Scholar 

  • Hampp EL, Sodhl N, Scholl L et al (2019b) Less iatrogenic soft-tissue damage utilizing robotic-assisted total knee arthroplasty when compared with a manual approach. Bone Joint Res 8:495–501

    Article  PubMed  PubMed Central  Google Scholar 

  • Jacofsky DJ, Allen M (2016) Robotics in arthroplasty: a comprehensive review. J Arthroplast 31(10):2353–2363

    Article  Google Scholar 

  • Jinnah AH, Luo TD, Plate JF, Jinnah RH (2019) General concepts in robotics in orthopedics. In: Lonner JH (ed) Robotics in knee and hip arthroplasty. Springer Nature, Cham

    Google Scholar 

  • Karunaratne S, Duan M, Pappas E, Fritsch B, Boyle R, Gupta S, Stalley P, Horsley M, Steffens D (2019) The effectiveness of robotic hip and knee arthroplasty on patient-reported outcomes: a systematic review and meta-analysis. Int Orthop 43(6):1283–1295

    Article  PubMed  Google Scholar 

  • Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS (2018a) Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. Bone Joint J 100-B(7):930–937

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kayani B, Konan S, Pietrzak JRT, Huq SS, Tahmassebi J, Haddad FS (2018b) The learning curve associated with robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study. Bone Joint J 100-B(8):1033–1042

    Article  CAS  PubMed  Google Scholar 

  • Kazarian GS, Lawrie CM, Barrack TN, Donaldson MJ, Miller GM, Haddad FS, Barrack RL (2019) The impact of surgeon volume and training status on implant alignment in total knee arthroplasty. J Bone Joint Surg Am 101(19):1713–1723

    Article  PubMed  Google Scholar 

  • Khlopas A, Sodhi N, Hozack WJ, Chen AF, Mahoney OM, Kinsey T, Orozco F, Mont MA (2020) Patient-reported functional and satisfaction outcomes after robotic-arm-assisted total knee arthroplasty: early results of a prospective multicenter investigation. J Knee Surg 33(07):685–690

    Article  PubMed  Google Scholar 

  • Kim YH, Yoon SH, Park JW (2019) Does robotic-assisted TKA result in better outcome scores or long-term survivorship than conventional TKA? A randomized, controlled trial. Clin Orthop Relat Res 478(2):266

    Article  PubMed Central  Google Scholar 

  • Koenig JA, Plaskos C (2019) Total knee arthroplasty technique: OMNIbotics. In: Lonner JH (ed) Robotics in knee and hip arthroplasty. Springer Nature, Cham

    Google Scholar 

  • Koenig JA, Suero EM, Plaskos C (2012) Surgical accuracy and efficiency of computer-navigated TKA with a robotic cutting guide–report on the first 100 cases. Orthopaedic Proc 94-B:103

    Google Scholar 

  • Lang JE, Mannava S, Floyd AJ et al (2011) Robotic systems in orthopaedic surgery. J Bone Joint Surg Br 93(10):1296–1299

    Article  CAS  PubMed  Google Scholar 

  • Liow MH, Xia Z, Wong MK, Tay KJ, Yeo SJ, Chin PL (2014) Robot-assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study. J Arthroplast 29(12):2373–2377

    Article  Google Scholar 

  • Lonner JH, Fillingham YA (2018) Pros and cons: a balanced view of robotics in knee arthroplasty. J Arthroplast 33(7):2007–2013

    Article  Google Scholar 

  • Lonner JH, Fillingham Y (2019) A brief history of robotics in surgery. In: Lonner JH (ed) Robotics in knee and hip arthroplasty. Springer Nature, Cham, pp 3–10

    Chapter  Google Scholar 

  • Lonner JH, Kerr G (2019) Low rate of iatrogenic complications during unicompartmental knee arthroplasty with two semiautonomous robotic systems. Knee 26(3):745–749

    Article  PubMed  Google Scholar 

  • Lonner JH, Klement MR (2019) Robotic-assisted medial unicompartmental knee arthroplasty: options and outcomes. J Am Acad Orthop Surg 27(5):e207–e214

    Article  PubMed  Google Scholar 

  • Lonner JH, Moretti VM (2016) The evolution of image-free robotic assistance in unicompartmental knee arthroplasty. Am J Orthop (Belle Mead NJ) 45:249–254

    Google Scholar 

  • Lynch AF, Rorabeck CH, Bourne RB (1987) Extensor mechanism complications following total knee arthroplasty. J Arthroplast 9:135–140

    Article  Google Scholar 

  • Malkani AL, Roche MW, Kolisek FR, Gustke KA, Hozack WJ, Sodhi N, Acuña A, Vakharia R, Salem HS, Jaggard C, Smith L, Mont MA (2019) New technology for total knee arthroplasty provides excellent patient-reported outcomes: a minimum two-year analysis. Surg Technol Int 36:276–280

    Google Scholar 

  • MDDI (2015) [cited 2015 March 5]. Available from: http://www.mddionline.com

  • Naziri Q, Cusson BC, Chaudhri M, Shah NV, Sastry A (2019) Making the transition from tradition to robotic-arm assited TKA: what to expect? A single-surgeon comparative-analysis of the first-40 consecutive cases. J Orthop 16(4):364–368

    Article  PubMed  PubMed Central  Google Scholar 

  • Newswire G (2016) Orthopedic surgical and surgical assist robots market – hip and knee orthopedic surgical robot device markets will reach $5 billion by 2022: ResearchMoz. [cited 2020 March 2]. Available from: https://www.globenewswire.com/newsrelease/2016/05/23/842396/0/en/Orthopedic-Surgical-and-Surgical-Assist-Robots-Market-Hip-and-Knee-Orthopedic-Surgical-Robot-Device-Markets-will-reach-5-billion-by-2022-ResearchMoz.html

  • Park SE, Lee CT (2007) Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty. J Arthroplast 22(7):1054–1059

    Article  Google Scholar 

  • Parratte S, Price AJ, Jeys LM, Jackson WF, Clarke HD (2019) Accuracy of a new robotically assisted technique for total knee arthroplasty: a cadaveric study. J Arthroplast 34(11):2799–2803

    Article  Google Scholar 

  • Ponzio DY, Lonner JH (2015) Preoperative mapping in unicompartmental knee arthroplasty using computed tomography scans is associated with radiation exposure and carries high cost. J Arthroplast 30:964–967

    Article  Google Scholar 

  • Ponzio DY, Lonner J (2016) Robotic technology produces more conservative tibial resection than conventional techniques in UKA. Am J Orthop (Belle Mead NJ) 45:e465–e468

    Google Scholar 

  • Rand JA, Morrey BF, Bryan RS (1989) Patellar tendon rupture after total knee arthroplasty. Clin Orthop Relat Res 244:233–238

    Article  Google Scholar 

  • Ren Y, Cao S, Wu J, Weng X, Feng B (2019) Efficacy and reliability of active robotic-assisted total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J 95(1121):125–133

    Article  PubMed  Google Scholar 

  • Schulz AP, Seide K, Queitsch C, von Haugwitz A, Meiners J, Kienast B, Tarabolsi M, Kammal M, Jürgens C (2007) Results of total hip replacement using the Robodoc surgical assistant system: clinical outcome and evaluation of complications for 97 procedures. Int J Med Robot 3:301–306

    Article  PubMed  Google Scholar 

  • Sharkey PF, Lo P, Shen C, Tokarski AT, Parvizi J (2014) Why are total knee arthroplasties failing today-has anything changed after 10 years? J Arthroplast 29:1774–1778

    Article  Google Scholar 

  • Siebert W, Mai S, Kober R, Heeckt PF (2002) Technique and first clinical results of robot-assisted total knee replacement. Knee 9(3):173–180

    Article  PubMed  Google Scholar 

  • Song EK, Seon JK, Park SJ, Jung WB, Park HW, Lee GW (2011) Simultaneous bilateral total knee arthroplasty with robotic and conventional techniques: a prospective, randomized study. Knee Surg Sports Traumatol Arthrosc 19(7):1069–1076

    Article  PubMed  Google Scholar 

  • Song EK, Seon JK, Yim JH, Netravali NA, Bargar WL (2013) Robotic-assisted TKA reduces postoperative alignment outliers and improves gap balance compared to conventional TKA. Clin Orthop Relat Res 471(1):118–126

    Article  PubMed  Google Scholar 

  • Yang HY, Seon YJ, Shim YJ, Lim HA, Song EK (2017) Robotic total knee arthroplasty with a cruciate-retaining implant: a 10-year follow-up study. Clin Orthop Surg 9(2):169–176

    Article  PubMed  PubMed Central  Google Scholar 

  • Yarbrough AK, Smith TB (2007) Technology acceptance among physicians: a new take on TAM. Med Care Res Rev 64:650–672

    Article  PubMed  Google Scholar 

  • Yim JH, Song EK, Khan MS, Sun ZH, Seon JK (2013) A comparison of classical and anatomical total knee alignment methods in robotic total knee arthroplasty: classical and anatomical knee alignment methods in TKA. J Arthroplast 28(6):932–937

    Article  Google Scholar 

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Krueger, C.A., Lonner, J.H. (2022). Robot-Assisted Total Knee Arthroplasty. In: Hansen, E., Kühn, KD. (eds) Essentials of Cemented Knee Arthroplasty. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63113-3_67

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  • DOI: https://doi.org/10.1007/978-3-662-63113-3_67

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