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Two- and three-dimensional evaluations following handheld robot-assisted total knee arthroplasty

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Abstract

Robot-assisted total knee arthroplasty (TKA) has proven to be successful in improving the accuracy of component positioning and reducing radiographic outliers. This study aimed to evaluate and compare the alignment of the components using two- and three-dimensional (2D and 3D) measurements following handheld imageless robot-assisted TKA. Seventy consecutive patients underwent primary TKA at our institution using a handheld robot-assisted system. Full‐length standing anteroposterior and lateral radiographs were obtained 2 weeks after surgery for assessment of 2D component alignments. Pre- and postoperative computed tomography (CT) images were obtained to assess 3D component alignment. The reference points defined on preoperative CT images were transferred to the postoperative CT images. The absolute errors in the 2D and 3D component alignments from the planned, validated cutting, and validated implantation angles were calculated. Outliers of >  ± 3° of femoral and tibial component alignments in the coronal and sagittal planes were also investigated. All absolute errors in the 2D and 3D component alignments were < 1°, except for the planned and validated cutting angles of the femoral sagittal alignment. No outliers were observed in the femoral or tibial component in the coronal plane. Significant differences between the 2D and 3D measurements were observed for the mean absolute value from the planned and validated cutting angles in the femoral sagittal plane and from the validated implantation angle in the tibial coronal plane. The handheld robot-assisted system demonstrated a high accuracy for component alignment using 2D and 3D evaluations.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Mie University, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Shine Tone, Masahiro Hasegawa, Yohei Naito, Hiroki Wakabayashi & Akihiro Sudo

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  1. Shine Tone
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  2. Masahiro Hasegawa
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  3. Yohei Naito
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  4. Hiroki Wakabayashi
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  5. Akihiro Sudo
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Contributions

ST: designed the study, collected and analyzed the data, participated operations, performed all operations, wrote the manuscript. MH: designed the study, performed all operations, edited the manuscript. YN: designed the study, participated operations, collected the data, edited the manuscript. HW: designed the study, participated operations. AS: designed the study, review and edited the manuscript.

Corresponding author

Correspondence to Masahiro Hasegawa.

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The authors declare that they have no competing interests.

Ethical approval

This study was approved by Institutional Review Board at Mie University hospital (No. H2018-083).

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Written informed consent was obtained from all individual participants included in the study.

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Tone, S., Hasegawa, M., Naito, Y. et al. Two- and three-dimensional evaluations following handheld robot-assisted total knee arthroplasty. J Robotic Surg 18, 70 (2024). https://doi.org/10.1007/s11701-024-01827-8

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