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Versatility and accuracy of a novel image-free robotic-assisted system for total knee arthroplasty

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

Abstract

Introduction

Technological advances alongside increased demand for knee replacement surgery have led to the development of a novel image-free bed rail-mounted robotic-assisted system for total knee arthroplasty (TKA). The device is capable of real-time tracking to accommodate for leg motion during bone resection allowing for precise control and positioning of the bone saw in the planned resection plane. The purpose of this study is to discuss the versatility and accuracy of this novel image-free robotic-assisted technology in TKA.

Methods and materials

The novel robotic-assisted system underwent a stepwise assessment to verify its versatility and accuracy. First, functional accuracy was bench tested to evaluate predetermined surgical plans independent of user variability and anatomic variability compared to conventional instrumentation. This was followed by assessments utilizing cadaveric specimens for resection accuracy, implant positioning, and soft tissue involvement.

Results

Test bench accuracy revealed overall pooled linear positional accuracy of 0.326 ± 0.249 mm and pooled angular positional accuracy of 0.365 ± 0.611°. Resection errors for both robotic and conventional cohorts ranged between 0.6° and 1.9°. Concerning coronal alignment, 33/40 robotic specimen were within ± 1° and 38/40 within ± 3° of the femoral varus–valgus target, compared with 17/40 and 37/40 with conventional instrumentation, respectively. Twenty-four of the 40 robotic specimens were within ± 1° and 40/40 within ± 3° of the tibial varus–valgus target compared with 15/40 and 32/40 with conventional instrumentation, respectively. Soft tissue structures were uncompromised in all robotic-assisted cases. Conventional instruments revealed two cases of partial cleavage of the posterior cruciate ligament and two instances of a compromised posterior medial capsule. There were no significant differences between the two techniques concerning the samples that were uncompromised and fully functional (40/40 vs. 38/40, p = 0.49).

Conclusion

The novel image-free robotic-assisted surgical system demonstrates excellent benchtop accuracy to aid bony resection in cadaveric specimens. It offers notable improvement in coronal implant alignment compared to conventional instrumentation.

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Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA

    Vivek Singh, Greg M. Teo & William J. Long

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  1. Vivek Singh
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  2. Greg M. Teo
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  3. William J. Long
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Corresponding author

Correspondence to William J. Long.

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Conflict of interest

V.S and G.M.T have nothing to disclose. W.J.L reports IP royalties from Ortho Development, personal fees from Microport, being a paid consultant for TJO, J&J, THINK Surgical, Convatec, Pacira, and KCI, outside the submitted work.

Ethical approval

The present study was exempt from human subjects review by our Institutional Review Board (IRB).

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Singh, V., Teo, G.M. & Long, W.J. Versatility and accuracy of a novel image-free robotic-assisted system for total knee arthroplasty. Arch Orthop Trauma Surg 141, 2077–2086 (2021). https://doi.org/10.1007/s00402-021-04049-x

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  • DOI: https://doi.org/10.1007/s00402-021-04049-x

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