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Intra-operative Safety of an Autonomous Robotic System for Total Knee Replacement: A Review of 500 Cases in India

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Abstract

Background

Manual total knee arthroplasty (TKA) has been documented several times for their safety and complications data. In contrast, there is a limited evidence-based analysis for safety and complications of autonomous robotic-assisted (RA)-TKA. This study aimed to evaluate the safety features and intra-operative surgical complications associated with the use of Cuvis Joint™ autonomous robotic system for TKA.

Methods

The study included 500 consecutive patients who underwent TKA using the Cuvis Joint™ autonomous robotic system from November 2020 to November 2021. All surgeries were performed by a senior surgeon. Patients in whom the surgery was abandoned midway due to technical errors, were excluded from the analysis. In case of unilateral abandonment of the robotic arm during a bilateral RA-TKA, data of the side on which the surgery was completed with robotic assistance was recorded.

Results

There was no incidence of neurological injury, vascular injury, extensor mechanism disruption, or medial collateral ligament injury. There was one case of superficial abrasion of the patellar tendon; however, it did not require any intervention. There were no cases of midway abandonment due to threatened soft tissue injury. There was no intra-operative pin loosening or stress-related fractures at the pin sites. There was one case of Steinmann pin breakage and another case of drill bit breakage, which were removed without any damage to the bone.

Conclusion

The Cuvis Joint™ autonomous robotic system for TKA is safe with no significant intra-operative complications.

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Abbreviations

BMM:

Bone movement monitor

CT:

Computed tomography

3D:

3-Dimensional

HKA:

Hip knee ankle

ICH-GCP:

International Conference on Harmonization Guideline for Good Clinical Practice

MCL:

Medial collateral ligament

RA-TKA:

Robotic arm-assisted total knee replacement

RMS:

Root mean square

TKA:

Total knee arthroplasty

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Authors and Affiliations

  1. Institute of Orthopaedics, Sakra World Hospital, Devarabeesanahalli, Bangalore, India

    P. Chandrashekar, K. Adarsh Babu, H. S. Nagaraja, S. Gangu Hiral & S. Karthikeyan

  2. Hip and Knee Specialist, Wockhardt Hospital, 1877, Dr Anandrao Nair Marg, Near Agripada, Mumbai Central, Mumbai, Maharashtra, India

    Supreet Bajwa

Authors
  1. P. Chandrashekar
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  2. K. Adarsh Babu
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  4. S. Gangu Hiral
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  5. S. Karthikeyan
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Correspondence to Supreet Bajwa.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics Approval

This study was initiated after the protocol was reviewed and approved by the local ethics committee according to local regulations. The study was carried out in conformity with the protocol and International Conference on Harmonization Guideline for Good Clinical Practice (ICH-GCP).

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For this type of study, informed consent is not required.

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Chandrashekar, P., Babu, K.A., Nagaraja, H.S. et al. Intra-operative Safety of an Autonomous Robotic System for Total Knee Replacement: A Review of 500 Cases in India. JOIO 57, 1800–1808 (2023). https://doi.org/10.1007/s43465-023-00970-y

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