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Concepts and techniques of a new robotically assisted technique for total knee arthroplasty: the ROSA knee system

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The ROSA (Robotic Surgical Assistant) Knee system (Zimmer Biomet, Warsaw, IN) for total knee arthroplasty (TKA) can be considered as collaborative robotics, where the surgeon remains in charge of the procedure and collaborates with a smart robotic tool, to perform the surgery with a high accuracy and reproducibility. The aim was to describe: (1) its concept and surgical technique; (2) its advantages and potential limits; (3) the early experience with this system.

Materials and methods

The goal during its development phase was to keep the surgeon active and at the center of the operation: the surgeon handles the saw and performs the cuts while the robotic arm places and holds the guide at the right place. The ROSA knee platform assists the surgeon for the distal femoral cut, the femoral component sizing and positioning, the tibial cut and the ligament balance. This robotic system has two options: image-based with 3D virtual model; or image-less, based on intraoperative landmarks acquisition. All the classic surgical techniques can be used: measured resection, gap balancing, functional alignment, kinematic alignment. Some techniques recently developed are more ROSA-specific: Robotic personalized TKA, ROSA-FuZion technique.

Results

Its advantages as compared to other available systems include: radiographs in standing position, collaborative robotic system where the robot completes the surgeon skills, “off-the-shelf” implants, predictive robotic with concept of machine learning incorporated into the system. Two cadaveric studies have reported the high accuracy and reproducibility of this device. This robotic system is recent and currently no clinical series has enough follow-up to report clinical outcomes.

Conclusion

The ROSA knee system is a robotically assisted semi-autonomous surgical system with some specific characteristics. The aim of this collaborative robotic system is to improve the accuracy and reliability of the bone resections and the ligament balancing, without replacing the steps well performed by the surgeon.

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Authors and Affiliations

  1. Orthopaedics Surgery and Sports Medicine Department, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France

    Cécile Batailler

  2. Department of Orthopaedic Surgery, Geneva University Hospitals, Geneva, Switzerland

    Didier Hannouche

  3. Sezione di Chirurgia Protesica ad Indirizzo Robotico—Unità di Traumatologia dello Sport, U.O. Ortopedia e Traumatologia Fondazione Poliambulanza, Brescia, Italy

    Francesco Benazzo

  4. Università degli Studi di Pavia, Pavia, Italy

    Francesco Benazzo

  5. International Knee and Joint Centre, Abu Dhabi, United Arab Emirates

    Sébastien Parratte

  6. Institute for Locomotion, Aix-Marseille University, Marseille, France

    Sébastien Parratte

Authors
  1. Cécile Batailler
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  2. Didier Hannouche
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  3. Francesco Benazzo
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  4. Sébastien Parratte
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Corresponding author

Correspondence to Cécile Batailler.

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Conflict of interest

CB: Grant from SoFCOT. DH: Consultant for Zimmer Biomet; Grants from Fondation pour la Recherche Ostéo-Articulaire. FB: Consultant for Zimmer Biomet and Limacorporate; Grants from Limacorporate; Royalties from Zimmer Biomet and Limacorporate. SP: Royalties from Zimmer Biomet and Newclip; Consultant for Zimmer Biomet; Treasurer for European Knee Society.

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Batailler, C., Hannouche, D., Benazzo, F. et al. Concepts and techniques of a new robotically assisted technique for total knee arthroplasty: the ROSA knee system. Arch Orthop Trauma Surg 141, 2049–2058 (2021). https://doi.org/10.1007/s00402-021-04048-y

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  • DOI: https://doi.org/10.1007/s00402-021-04048-y

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