Assessment of Limb Alignment and Component Placement After All Burr Robotic-Assisted TKA
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ORIGINAL ARTICLE
Assessment of Limb Alignment and Component Placement After All Burr Robotic‑Assisted TKA Mukesh Laddha1 · Sahu Gaurav2 Received: 12 May 2020 / Accepted: 18 September 2020 © Indian Orthopaedics Association 2020
Abstract Background All burr robotic-assisted total knee arthroplasty (R-TKA) is the new way of doing TKA without conventional jigs and saw. The aim of this study is to assess the accuracy of limb alignment and component placement after R-TKA. Methods and Materials This is the prospective study of 63 patients who underwent R-TKA between March and October 2019. Standing scanogram and AP/lateral radiograph were done on day of discharge, 5th day after surgery to calculate limb alignment and component placement angles in coronal and sagittal plane. Deformity correction Bone Ninja software had been used to calculate all this angles. Results Mean difference between robotic achieved and postoperative limb alignment was 1.24°. Mean difference between planned and achieved component placement in coronal and sagittal plane for tibia was 0.33° and 0.66° and for femur was 0.62° and 0.30°, respectively. Posterior condylar offset difference was 0.03. As per planned by Navio software, R-TKA had reduced the overall outlier of coronal limb alignment from 3° to less than 1.2° and component placement malposition to less than 1° in coronal and sagittal plane. Conclusion R-TKA provides near perfect limb alignment and near accurate femoral/tibial component placement as planned in both coronal and sagittal plane. Posterior condylar offset was also perfectly maintained. R-TKA had reduced the overall outlier of coronal limb alignment from 3° to less than 1.2° and component placement malposition to less than 1° in coronal and sagittal plane. Keywords Robotic TKA · Component placement · Limb alignment · PCO · TKA
Introduction End-stage arthritis of the knee is effectively managed with total knee arthroplasty (TKA) [1]. According to the database of Healthcare Cost and Utilization Project (HCUP) and Journal of American Medical Association 600,000 TKAs were performed by 2010 [2]. Most of TKAs significantly relieves pain and improve functional outcome [3], but 20% patients * Mukesh Laddha [email protected]; [email protected] Sahu Gaurav [email protected] 1
Robotic Joint Replacement and Arthroscopy Specialist (Shoulder, Knee and Hip Surgeon), RNH Hospital, Balraj Marg, Near Dhantoli Garden, Dhantoli, Nagpur, Maharashtra 440022, India
Consultant Orthopaedic Surgeon, Dhamtari Christian Hospital, Dhamtari, Chhattisgarh, India
2
were unsatisfied within 1 year of surgery [4, 5]. Thus, it is of significance to achieve the perfect component placement or alignment in all three planes with neutrally aligned limb with mechanical axis 180° ± 3° and no tibia–femoral rotational mismatch [6, 7]. In frontal plane, varus or valgus deviations of > 3° are associated with an increased loosening rate [8]. In sagittal plane, posterior tilting of tibial component affects femoral rollback on tibia [9]. In transvers
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