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Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

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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Abbreviations

BMI:

Body mass index

CT scan:

Computerised tomography scan

HKA angle:

Hip knee ankle angle

TKA:

Total knee arthroplasty

UKA:

Unicompartmental knee arthroplasty

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Funding

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Author information

Authors and Affiliations

  1. Orthopedic Surgery Department, Croix-Rousse Hospital, Lyon, France

    Cécile Batailler, Nathan White, Filippo Maria Ranaldi, Philippe Neyret, Elvire Servien & Sébastien Lustig

Authors
  1. Cécile Batailler
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  2. Nathan White
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  3. Filippo Maria Ranaldi
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  4. Philippe Neyret
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  5. Elvire Servien
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  6. Sébastien Lustig
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Contributions

CB: study design, data collection, statistical analysis, literature review and manuscript writing. NW: study design, literature review and manuscript editing. FR: study design and literature review. PN and ES: study design and manuscript editing. SL: study design, supervision, literature review and manuscript editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cécile Batailler.

Ethics declarations

Conflict of interest

CB, NW and FR declare that they have no conflict of interest. PN: consultant for Smith and Nephew, royalties from Tornier-Wright, institutional research support to Tornier-Wright and Amplitude. ES: consultant for Smith and Nephew. SL: consultant for Smith and Nephew, institutional research support to Tornier-Wright and Amplitude.

Ethical approval

The Advisory Committee on Research Information Processing in the Field of Health (CCTIRS) approved this study in Paris on February 17, 2016 under number 16–140.

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Batailler, C., White, N., Ranaldi, F.M. et al. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 27, 1232–1240 (2019). https://doi.org/10.1007/s00167-018-5081-5

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  • DOI: https://doi.org/10.1007/s00167-018-5081-5

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