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Outcomes of robotic-arm-assisted medial unicompartmental knee arthroplasty: minimum 3-year follow-up

  • Original Article • KNEE - ARTHROPLASTY
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Abstract

The purpose of this study was to determine implant survivorship, complications, and re-operation rates, after robotic arm-assisted unicompartmental knee arthroplasty (UKA) at intermediate follow-up. Patient satisfaction and clinical outcome were further investigated, in addition to an analysis of restoration of knee alignment. Fifty-one patients, who received a robotic arm-assisted medial UKA, were prospectively studied, and followed for a minimum of 3 years (mean 51.4 ± 4.5 months). Survival of implants, complications, reoperations, and patients’ overall satisfaction were evaluated. WOMAC scores, as well as knee flexion, varus deformity and flexion contracture were further analyzed, before and after surgery. No implant failure or implant-related complication was recorded, and no revision surgery was performed at the last follow-up in any patient. Overall satisfaction was excellent; 96.1% of patients, at the latest follow-up, was satisfied or very satisfied, while none was dissatisfied or very dissatisfied. Total WOMAC score and each score’s component was significantly improved after surgery. Knee alignment was significantly improved, as flexion increased, varus decreased, and flexion contracture also decreased. In conclusion, robotic-arm-assisted UKA, through accurate implant positioning, significantly improves range of motion and coronal plane alignment, in appropriately selected patients. Excellent overall satisfaction rates and clinical outcomes can be expected, at intermediate follow-up, along with excellent survival of implants and minimal to none surgery-related morbidity.

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References

  1. Borus T, Thornhill T (2008) Unicompartmental knee arthroplasty. J Am Acad Orthop Surg 16(1):9–18

    Article  PubMed  Google Scholar 

  2. Christ AB, Pearle AD, Mayman DJ, Haas SB (2018) Robotic-assisted unicompartmental knee arthroplasty: state-of-the art and review of the literature. J Arthroplasty 33(7):1994–2001. https://doi.org/10.1016/j.arth.2018.01.050

    Article  PubMed  Google Scholar 

  3. Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S (2017) Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop 41(11):2265–2271. https://doi.org/10.1007/s00264-017-3633-9

    Article  PubMed  Google Scholar 

  4. Pearle AD, van der List JP, Lee L, Coon TM, Borus TA, Roche MW (2017) Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up. Knee 24(2):419–428. https://doi.org/10.1016/j.knee.2016.12.001

    Article  PubMed  PubMed Central  Google Scholar 

  5. Fisher DA, Dalury DF, Adams MJ, Shipps MR, Davis K (2010) Unicompartmental and total knee arthroplasty in the over 70 population. Orthopedics 33(9):668. https://doi.org/10.3928/01477447-20100722-05

    Article  PubMed  Google Scholar 

  6. Patil S, Colwell CW Jr, Ezzet KA, D’Lima DD (2005) Can normal knee kinematics be restored with unicompartmental knee replacement? J Bone Joint Surg Am 87(2):332–338. https://doi.org/10.2106/JBJS.C.01467

    Article  PubMed  Google Scholar 

  7. Schwab PE, Lavand’homme P, Yombi JC, Thienpont E (2015) Lower blood loss after unicompartmental than total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 23(12):3494–3500. https://doi.org/10.1007/s00167-014-3188-x

    Article  PubMed  Google Scholar 

  8. Blyth MJG, Anthony I, Rowe P, Banger MS, MacLean A, Jones B (2017) Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: exploratory secondary analysis of a randomised controlled trial. Bone Joint Res 6(11):631–639. https://doi.org/10.1302/2046-3758.611.BJR-2017-0060.R1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Badawy M, Espehaug B, Indrekvam K, Havelin LI, Furnes O (2014) Higher revision risk for unicompartmental knee arthroplasty in low-volume hospitals. Acta Orthop 85(4):342–347. https://doi.org/10.3109/17453674.2014.920990

    Article  PubMed  PubMed Central  Google Scholar 

  10. Keene G, Simpson D, Kalairajah Y (2006) Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Joint Surg Br 88(1):44–48. https://doi.org/10.1302/0301-620X.88B1.16266

    Article  CAS  PubMed  Google Scholar 

  11. Khamaisy S, Gladnick BP, Nam D, Reinhardt KR, Heyse TJ, Pearle AD (2015) Lower limb alignment control: is it more challenging in lateral compared to medial unicondylar knee arthroplasty? Knee 22(4):347–350. https://doi.org/10.1016/j.knee.2015.02.018

    Article  PubMed  Google Scholar 

  12. Nam D, Khamaisy S, Gladnick BP, Paul S, Pearle AD (2013) Is tibiofemoral subluxation correctable in unicompartmental knee arthroplasty? J Arthroplasty 28(9):1575–1579. https://doi.org/10.1016/j.arth.2013.03.001

    Article  PubMed  Google Scholar 

  13. Plate JF, Mofidi A, Mannava S, Smith BP, Lang JE, Poehling GG, Conditt MA, Jinnah RH (2013) Achieving accurate ligament balancing using robotic-assisted unicompartmental knee arthroplasty. Adv Orthop 2013:837167. https://doi.org/10.1155/2013/837167

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg Am 98(8):627–635. https://doi.org/10.2106/JBJS.15.00664

    Article  PubMed  Google Scholar 

  15. Citak M, Suero EM, Citak M, Dunbar NJ, Branch SH, Conditt MA, Banks SA, Pearle AD (2013) Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique? Knee 20(4):268–271. https://doi.org/10.1016/j.knee.2012.11.001

    Article  PubMed  Google Scholar 

  16. Dunbar NJ, Roche MW, Park BH, Branch SH, Conditt MA, Banks SA (2012) Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty. J Arthroplasty 27(5):803–808. https://doi.org/10.1016/j.arth.2011.09.021

    Article  PubMed  Google Scholar 

  17. Lonner JH, John TK, Conditt MA (2010) Robotic arm-assisted UKA improves tibial component alignment: a pilot study. Clin Orthop Relat Res 468(1):141–146. https://doi.org/10.1007/s11999-009-0977-5

    Article  PubMed  Google Scholar 

  18. Jacofsky DJ, Allen M (2016) Robotics in arthroplasty: a comprehensive review. J Arthroplasty 31(10):2353–2363. https://doi.org/10.1016/j.arth.2016.05.026

    Article  PubMed  Google Scholar 

  19. van der List JP, Zuiderbaan HA, Pearle AD (2016) Why do medial unicompartmental knee arthroplasties fail today? J Arthroplasty 31(5):1016–1021. https://doi.org/10.1016/j.arth.2015.11.030

    Article  PubMed  Google Scholar 

  20. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15(12):1833–1840

    CAS  PubMed  Google Scholar 

  21. Kleeblad LJ, Borus TA, Coon TM, Dounchis J, Nguyen JT, Pearle AD (2018) Midterm survivorship and patient satisfaction of robotic-arm-assisted medial unicompartmental knee arthroplasty: a multicenter study. J Arthroplasty 33(6):1719–1726. https://doi.org/10.1016/j.arth.2018.01.036

    Article  PubMed  Google Scholar 

  22. Wong T, Wang CJ, Wang JW, Ko JY (2014) Functional outcomes of uni-knee arthroplasty for medial compartment knee arthropathy in asian patients. Biomed J 37(6):406–410. https://doi.org/10.4103/2319-4170.132877

    Article  PubMed  Google Scholar 

  23. Gaudiani MA, Nwachukwu BU, Baviskar JV, Sharma M, Ranawat AS (2017) Optimization of sagittal and coronal planes with robotic-assisted unicompartmental knee arthroplasty. Knee 24(4):837–843. https://doi.org/10.1016/j.knee.2017.05.002

    Article  PubMed  Google Scholar 

  24. Roche M (2015) Robotic-assisted unicompartmental knee arthroplasty: the MAKO experience. Orthop Clin North Am 46(1):125–131. https://doi.org/10.1016/j.ocl.2014.09.008

    Article  PubMed  Google Scholar 

  25. Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22(2):117–121. https://doi.org/10.1016/j.knee.2014.12.004

    Article  PubMed  Google Scholar 

  26. Zuiderbaan HA, van der List JP, Chawla H, Khamaisy S, Thein R, Pearle AD (2016) Predictors of subjective outcome after medial unicompartmental knee arthroplasty. j arthroplasty 31(7):1453–1458. https://doi.org/10.1016/j.arth.2015.12.038

    Article  PubMed  Google Scholar 

  27. Chatellard R, Sauleau V, Colmar M, Robert H, Raynaud G, Brilhault J (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99(4 Suppl):S219–S225. https://doi.org/10.1016/j.otsr.2013.03.004

    Article  CAS  PubMed  Google Scholar 

  28. Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86-A(3):506–511

    Article  Google Scholar 

  29. Small SR, Berend ME, Rogge RD, Archer DB, Kingman AL, Ritter MA (2013) Tibial loading after UKA: evaluation of tibial slope, resection depth, medial shift and component rotation. J Arthroplasty 28(9 Suppl):179–183. https://doi.org/10.1016/j.arth.2013.01.004

    Article  PubMed  Google Scholar 

  30. Nunley RM, Nam D, Johnson SR, Barnes CL (2014) Extreme variability in posterior slope of the proximal tibia: measurements on 2395 CT scans of patients undergoing UKA? J Arthroplasty 29(8):1677–1680. https://doi.org/10.1016/j.arth.2014.03.024

    Article  PubMed  PubMed Central  Google Scholar 

  31. MacCallum KP, Danoff JR, Geller JA (2016) Tibial baseplate positioning in robotic-assisted and conventional unicompartmental knee arthroplasty. Eur J Orthop Surg Traumatol 26(1):93–98. https://doi.org/10.1007/s00590-015-1708-0

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Second Department of Orthopaedics, Hygeia Hospital, Athens, Greece

    Konstantinos Dretakis

  2. School of Medicine, National and Kapodistrian University of Athens, 32 Sismanogliou St., Neo Iraklio, Athens, Greece

    Vasilios G. Igoumenou

Authors
  1. Konstantinos Dretakis
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  2. Vasilios G. Igoumenou
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Correspondence to Vasilios G. Igoumenou.

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Dretakis, K., Igoumenou, V.G. Outcomes of robotic-arm-assisted medial unicompartmental knee arthroplasty: minimum 3-year follow-up. Eur J Orthop Surg Traumatol 29, 1305–1311 (2019). https://doi.org/10.1007/s00590-019-02424-4

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  • DOI: https://doi.org/10.1007/s00590-019-02424-4

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