Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2021
ReviewRobotic-assisted total knee arthroplasty with the OMNIBot platform: a review of the principles of use and outcomes.
Technology that enables the orthopaedic surgeon to deliver a surgical plan with precision and reproducibility continues to evolve. Robotic TKA represents the next phase of technological development in knee arthroplasty. Multiple propriety robotic platforms are now available for use in TKA, and one such system is the OMNIBotics platform. We conducted a review of this system, reporting its history and principles of use, published outcomes and our own personal experience performing OMNI robotic-assisted TKAs. ⋯ The OMNIBot platform is an imageless, passive robotic system available since 2007, with over 30,000 TKA's being performed with its assistance. It has a small physical footprint, is relatively inexpensive and time efficient. Our review demonstrates a high level of precision of the surgical planning, with a modestly improved accuracy compared to conventional and navigation technology. Published outcomes are limited, however demonstrate good short-term PROM's and survivorship data that compare favourably to other robotic TKA cohorts.
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Arch Orthop Trauma Surg · Dec 2021
ReviewCustom total knee: understanding the indication and process.
Patient-specific total knee arthroplasty (TKA) is a copy of the bony knee morphology based on a pre-op computer tomography (CT). The images are segmented in 3D and software is utilized through a proprietary process to generate individual total knee implants to recreate the articulating surfaces. The distal condylar valgus angle of the prosthesis is matched anatomically to the distal femur and reversely matched on the tibia with a thicker lateral insert. ⋯ The system is available with one solid or two separated medial and lateral PE inserts. There is a cruciate retaining (CR) and posterior stabilized (PS) version available, including various insert thicknesses. The system allows the addition of two different cemented stem extensions if needed at the time of surgery.
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Arch Orthop Trauma Surg · Dec 2021
ReviewConcepts and techniques of a new robotically assisted technique for total knee arthroplasty: the ROSA knee system.
The ROSA (Robotic Surgical Assistant) Knee system (Zimmer Biomet, Warsaw, IN) for total knee arthroplasty (TKA) can be considered as collaborative robotics, where the surgeon remains in charge of the procedure and collaborates with a smart robotic tool, to perform the surgery with a high accuracy and reproducibility. The aim was to describe: (1) its concept and surgical technique; (2) its advantages and potential limits; (3) the early experience with this system. ⋯ The ROSA knee system is a robotically assisted semi-autonomous surgical system with some specific characteristics. The aim of this collaborative robotic system is to improve the accuracy and reliability of the bone resections and the ligament balancing, without replacing the steps well performed by the surgeon.
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Arch Orthop Trauma Surg · Dec 2021
ReviewA novel augmented reality-based surgical guidance system for total knee arthroplasty.
Many of the functional complications that arise after total knee arthroplasty (TKA) are caused by a non-optimal balance of the knee after surgery. Over the past 20 years, technology has been used in the Operating Room (OR) to help improve precision and balance. The results of Computer-Assisted Surgery (CAS) and robotic systems show improved accuracy regarding implant positioning but a relatively small improvement in patient-reported outcomes and implant survival compared to conventional TKA. Recently, Augmented Reality (AR) has been proposed as a technology that could improve accuracy in orthopaedic surgery, providing a more efficient and cost-effective solution. ⋯ Augmented Reality can be a valuable tool to improve accuracy in TKA. The use of smart glasses and integrated sensors improves the efficiency of the procedure, particularly when coupled with single-use instrumentation. A novel protocol for soft tissue assessment allows for a 3-dimensional evaluation of the ligaments and a better measurement of the effect of tibial rotation.
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Arch Orthop Trauma Surg · Dec 2021
Current role of intraoperative sensing technology in total knee arthroplasty.
Sensors have been introduced within the last 10 years to quantify soft tissue balancing during total knee arthroplasty (TKA) and to give the surgeon objective data. These devices are fairly new and their impact on patient outcome remains uncertain. The aim of this systematic review was to summarize all the relevant surgical and clinical results of sensors for TKA. ⋯ Even though the use of the intraoperative sensing technology was not related to an improvement in clinical outcome, the current studies showed that using sensors facilitates the reproduction of natural joint stability, and improves the rate of achieving a balanced knee. Sensor use in complex cases could be particularly valuable, but their use in standard practice remains to be defined.