Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2021
Review Meta AnalysisRobotic-assisted knee arthroplasty: an evolution in progress. A concise review of the available systems and the data supporting them.
A review of the data supporting robotic systems currently available is presented focussing on precision and reproducibility, radiological outcomes, clinical outcomes, and survivorship. ⋯ This review adds to the body of evidence supporting improved precision and reproducibility with robotic assistance in knee arthroplasty. Despite intensive funding of research into robotic knee systems, there remains considerable heterogeneity in exposure and outcome analysis and few quality long-term studies demonstrating translation to better clinical outcomes and implant survivorship.
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Arch Orthop Trauma Surg · Dec 2021
ReviewContemporary knee arthroplasty: one fits all or time for diversity?
Total knee arthroplasty (TKA) has historically been the preferred solution for any type of knee osteoarthritis, independently of the number of compartments involved. In these days of patient-specific medicine, mono-compartmental disease could also be approached with a more individualized treatment, such as partial knee arthroplasty (PKA). Off-the-shelf (OTS) implants are often the compromise of averages and means of a limited series of anatomical parameters retrieved from patients and the pressure of cost control by limited inventory. Personalized medicine requires respect and interest for the individual shape and alignment of each patient. ⋯ TKA might not be the only solution for every patient with knee osteoarthritis, if personalized medicine wants to be offered. Patient-specific mono-compartmental resurfacing solutions, such as partial knee arthroplasty, can be part of the treatment options proposed by the expert surgeon. Customized implants and personalized alignment options have the potential to further improve clinical outcome by identifying the individual morphotype and respecting the diversity of the surgical population.
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Arch Orthop Trauma Surg · Dec 2021
ReviewCustomised, individually made total knee arthroplasty shows promising 1-year clinical and patient reported outcomes.
Customised individually made (CIM) implants for total knee arthroplasty (TKA) were introduced about 10 years ago. These implants aim to reduce the risk of prosthesis-related issues resulting from anthropometric differences between different knees. The purpose of this study was to analyse the short-term clinical outcome and patient reported outcome measures (PROMs) of a specific CIM implant, the ORIGIN® knee replacement system (Symbios, Yverdon-les-Bains, Switzerland), which was introduced in 2018. ⋯ The present study demonstrated significant improvements in the KSS and specific PROMs 1 year after CIM TKA. This study suggests that CIM TKA is a safe and suitable option, which can yield good clinical outcome and PROMs at least during short-term follow-up.
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Arch Orthop Trauma Surg · Dec 2021
Multicenter StudyImpact of intra-operative predictive ligament balance on post-operative balance and patient outcome in TKA: a prospective multicenter study.
New technologies exist which may assist surgeons to better predict final intra-operative joint balance. Our objectives were to compare the impact of (1) a predictive digital joint tensioning tool on intra-operative joint balance; and (2) joint balance and flexion joint laxity on patient-reported outcomes. ⋯ Use of a predictive joint tensioning tool improved the final balance in TKA. Improved outcomes were found in balanced knees; however, this improvement did not achieve the MCID, suggesting further studies may be required to define optimal balance targets. Limiting medial and lateral flexion laxity resulted in an increased likelihood of achieving the Patient Acceptable Symptom State for KOOS Pain.
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Arch Orthop Trauma Surg · Dec 2021
ReviewComponent placement accuracy in two generations of handheld robotics-assisted knee arthroplasty.
Total knee arthroplasty (TKA) is the gold standard for treatment of end-stage osteoarthritis. Previous studies have shown that successful outcomes following TKA depend on accurate implant alignment and soft tissue balancing. Robotic-assisted TKA have demonstrated improved accuracy in component placement and have been associated with better outcomes and patient satisfaction. This study aims to report on the execution accuracy of two generations of handheld robotic-assisted surgical systems. ⋯ Robotic-assisted knee replacement using handheld image-free systems is able to maintain accuracy of component placement. Further investigation of patient reported outcomes as well as long-term implant longevity are needed.