Improved accuracy of component positioning with robotic assisted unicompartmental knee arthroplasty

data from a prospective, randomised controlled study

Stuart W. Bell, Iain Anthony, Bryn Jones, Angus MacLean, Philip Rowe, Mark Blyth

Research output: Contribution to journalArticle

50 Citations (Scopus)
41 Downloads (Pure)

Abstract

Higher revision rates have been reported in patients who have undergone unicompartmental knee arthroplasty compared with patients who have undergone total knee arthroplasty, with poor component positioning identified as a factor in implant failure. A robotic-assisted surgical procedure has been proposed as a method of improving the accuracy of component implantation in arthroplasty. The aim of this prospective, randomized, single-blinded, controlled trial was to evaluate the accuracy of component positioning in unicompartmental knee arthroplasty comparing robotic-assisted and conventional implantation techniques. One hundred and thirty-nine patients were randomly assigned to treatment with either a robotic-assisted surgical procedure using the MAKO Robotic Interactive Orthopaedic Arm (RIO) system or a conventional surgical procedure using the Oxford Phase-3 unicompartmental knee replacement with traditional instrumentation. A postoperative computed tomographic scan was performed at three months to assess the accuracy of the axial, coronal, and sagittal component positioning. Data were available for 120 patients, sixty-two who had undergone robotic-assisted unicompartmental knee arthroplasty and fifty-eight who had undergone conventional unicompartmental knee arthroplasty. Intraobserver agreement was good for all measured component parameters. The accuracy of component positioning was improved with the use of the robotic-assisted surgical procedure, with lower root mean square errors and significantly lower median errors in all component parameters (p < 0.01). The proportion of patients with component implantation within 2° of the target position was significantly greater in the group who underwent robotic-assisted unicompartmental knee arthroplasty compared with the group who underwent conventional unicompartmental knee arthroscopy with regard to the femoral component sagittal position (57% compared with 26%, p = 0.0008), femoral component coronal position (70% compared with 28%, p = 0.0001), femoral component axial position (53% compared with 31%, p = 0.0163), tibial component sagittal position (80% compared with 22%, p = 0.0001), and tibial component axial position (48% compared with 19%, p = 0.0009). Robotic-assisted surgical procedures with the use of the MAKO RIO lead to improved accuracy of implant positioning compared with conventional unicompartmental knee arthroplasty surgical techniques.
Original languageEnglish
Pages (from-to)627-635
Number of pages9
JournalJournal of Bone and Joint Surgery - British
Volume98
Issue number8
DOIs
Publication statusPublished - 20 Apr 2016

Fingerprint

Arthroplasty
Knee Replacement Arthroplasties
Robotics
Thigh
Orthopedics
Arm
Knee prostheses
Arthroscopy
Mean square error
Knee
Robotic Surgical Procedures

Keywords

  • knee arthroplasty
  • limb malalignment
  • implant positioning
  • robotic assisted surgical procedures

Cite this

@article{9f0e0862b7f34c2f8fc80a84867bba0c,
title = "Improved accuracy of component positioning with robotic assisted unicompartmental knee arthroplasty: data from a prospective, randomised controlled study",
abstract = "Higher revision rates have been reported in patients who have undergone unicompartmental knee arthroplasty compared with patients who have undergone total knee arthroplasty, with poor component positioning identified as a factor in implant failure. A robotic-assisted surgical procedure has been proposed as a method of improving the accuracy of component implantation in arthroplasty. The aim of this prospective, randomized, single-blinded, controlled trial was to evaluate the accuracy of component positioning in unicompartmental knee arthroplasty comparing robotic-assisted and conventional implantation techniques. One hundred and thirty-nine patients were randomly assigned to treatment with either a robotic-assisted surgical procedure using the MAKO Robotic Interactive Orthopaedic Arm (RIO) system or a conventional surgical procedure using the Oxford Phase-3 unicompartmental knee replacement with traditional instrumentation. A postoperative computed tomographic scan was performed at three months to assess the accuracy of the axial, coronal, and sagittal component positioning. Data were available for 120 patients, sixty-two who had undergone robotic-assisted unicompartmental knee arthroplasty and fifty-eight who had undergone conventional unicompartmental knee arthroplasty. Intraobserver agreement was good for all measured component parameters. The accuracy of component positioning was improved with the use of the robotic-assisted surgical procedure, with lower root mean square errors and significantly lower median errors in all component parameters (p < 0.01). The proportion of patients with component implantation within 2° of the target position was significantly greater in the group who underwent robotic-assisted unicompartmental knee arthroplasty compared with the group who underwent conventional unicompartmental knee arthroscopy with regard to the femoral component sagittal position (57{\%} compared with 26{\%}, p = 0.0008), femoral component coronal position (70{\%} compared with 28{\%}, p = 0.0001), femoral component axial position (53{\%} compared with 31{\%}, p = 0.0163), tibial component sagittal position (80{\%} compared with 22{\%}, p = 0.0001), and tibial component axial position (48{\%} compared with 19{\%}, p = 0.0009). Robotic-assisted surgical procedures with the use of the MAKO RIO lead to improved accuracy of implant positioning compared with conventional unicompartmental knee arthroplasty surgical techniques.",
keywords = "knee arthroplasty, limb malalignment, implant positioning, robotic assisted surgical procedures",
author = "Bell, {Stuart W.} and Iain Anthony and Bryn Jones and Angus MacLean and Philip Rowe and Mark Blyth",
year = "2016",
month = "4",
day = "20",
doi = "10.2106/JBJS.15.00664",
language = "English",
volume = "98",
pages = "627--635",
journal = "The Bone and Joint Journal",
issn = "2049-4394",
number = "8",

}

Improved accuracy of component positioning with robotic assisted unicompartmental knee arthroplasty : data from a prospective, randomised controlled study. / Bell, Stuart W.; Anthony, Iain; Jones, Bryn; MacLean, Angus; Rowe, Philip; Blyth, Mark.

In: Journal of Bone and Joint Surgery - British, Vol. 98, No. 8, 20.04.2016, p. 627-635.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Improved accuracy of component positioning with robotic assisted unicompartmental knee arthroplasty

T2 - data from a prospective, randomised controlled study

AU - Bell, Stuart W.

AU - Anthony, Iain

AU - Jones, Bryn

AU - MacLean, Angus

AU - Rowe, Philip

AU - Blyth, Mark

PY - 2016/4/20

Y1 - 2016/4/20

N2 - Higher revision rates have been reported in patients who have undergone unicompartmental knee arthroplasty compared with patients who have undergone total knee arthroplasty, with poor component positioning identified as a factor in implant failure. A robotic-assisted surgical procedure has been proposed as a method of improving the accuracy of component implantation in arthroplasty. The aim of this prospective, randomized, single-blinded, controlled trial was to evaluate the accuracy of component positioning in unicompartmental knee arthroplasty comparing robotic-assisted and conventional implantation techniques. One hundred and thirty-nine patients were randomly assigned to treatment with either a robotic-assisted surgical procedure using the MAKO Robotic Interactive Orthopaedic Arm (RIO) system or a conventional surgical procedure using the Oxford Phase-3 unicompartmental knee replacement with traditional instrumentation. A postoperative computed tomographic scan was performed at three months to assess the accuracy of the axial, coronal, and sagittal component positioning. Data were available for 120 patients, sixty-two who had undergone robotic-assisted unicompartmental knee arthroplasty and fifty-eight who had undergone conventional unicompartmental knee arthroplasty. Intraobserver agreement was good for all measured component parameters. The accuracy of component positioning was improved with the use of the robotic-assisted surgical procedure, with lower root mean square errors and significantly lower median errors in all component parameters (p < 0.01). The proportion of patients with component implantation within 2° of the target position was significantly greater in the group who underwent robotic-assisted unicompartmental knee arthroplasty compared with the group who underwent conventional unicompartmental knee arthroscopy with regard to the femoral component sagittal position (57% compared with 26%, p = 0.0008), femoral component coronal position (70% compared with 28%, p = 0.0001), femoral component axial position (53% compared with 31%, p = 0.0163), tibial component sagittal position (80% compared with 22%, p = 0.0001), and tibial component axial position (48% compared with 19%, p = 0.0009). Robotic-assisted surgical procedures with the use of the MAKO RIO lead to improved accuracy of implant positioning compared with conventional unicompartmental knee arthroplasty surgical techniques.

AB - Higher revision rates have been reported in patients who have undergone unicompartmental knee arthroplasty compared with patients who have undergone total knee arthroplasty, with poor component positioning identified as a factor in implant failure. A robotic-assisted surgical procedure has been proposed as a method of improving the accuracy of component implantation in arthroplasty. The aim of this prospective, randomized, single-blinded, controlled trial was to evaluate the accuracy of component positioning in unicompartmental knee arthroplasty comparing robotic-assisted and conventional implantation techniques. One hundred and thirty-nine patients were randomly assigned to treatment with either a robotic-assisted surgical procedure using the MAKO Robotic Interactive Orthopaedic Arm (RIO) system or a conventional surgical procedure using the Oxford Phase-3 unicompartmental knee replacement with traditional instrumentation. A postoperative computed tomographic scan was performed at three months to assess the accuracy of the axial, coronal, and sagittal component positioning. Data were available for 120 patients, sixty-two who had undergone robotic-assisted unicompartmental knee arthroplasty and fifty-eight who had undergone conventional unicompartmental knee arthroplasty. Intraobserver agreement was good for all measured component parameters. The accuracy of component positioning was improved with the use of the robotic-assisted surgical procedure, with lower root mean square errors and significantly lower median errors in all component parameters (p < 0.01). The proportion of patients with component implantation within 2° of the target position was significantly greater in the group who underwent robotic-assisted unicompartmental knee arthroplasty compared with the group who underwent conventional unicompartmental knee arthroscopy with regard to the femoral component sagittal position (57% compared with 26%, p = 0.0008), femoral component coronal position (70% compared with 28%, p = 0.0001), femoral component axial position (53% compared with 31%, p = 0.0163), tibial component sagittal position (80% compared with 22%, p = 0.0001), and tibial component axial position (48% compared with 19%, p = 0.0009). Robotic-assisted surgical procedures with the use of the MAKO RIO lead to improved accuracy of implant positioning compared with conventional unicompartmental knee arthroplasty surgical techniques.

KW - knee arthroplasty

KW - limb malalignment

KW - implant positioning

KW - robotic assisted surgical procedures

UR - http://www.scopus.com/inward/record.url?scp=84979210929&partnerID=8YFLogxK

U2 - 10.2106/JBJS.15.00664

DO - 10.2106/JBJS.15.00664

M3 - Article

VL - 98

SP - 627

EP - 635

JO - The Bone and Joint Journal

JF - The Bone and Joint Journal

SN - 2049-4394

IS - 8

ER -