J Knee Surg 2021; 34(07): 745-748
DOI: 10.1055/s-0039-1700570
Original Article

Accuracy of Bone Resection in MAKO Total Knee Robotic-Assisted Surgery

1   College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
,
Johnathan D. Craik
2   Department of Orthopaedics, Flinders Medical Centre, Adelaide, South Australia, Australia
,
Christopher J. Wilson
2   Department of Orthopaedics, Flinders Medical Centre, Adelaide, South Australia, Australia
› Author Affiliations

Abstract

Accurate component positioning and planning is vital to prevent malalignment of total knee arthroplasty (TKA) as malalignment is associated with an increased rate of polyethylene wear and revision arthroplasty. The MAKO total knee robotic arm-assisted surgery (Stryker, Kalamazoo, MI) uses a preoperative computed tomography scan of the patient's knee and three-dimensional planning to size and orientate implants prior to bone resection. The aim of this study was to determine the accuracy of the MAKO Total Knee system in achieving the preoperative plan for bone resection and final limb coronal alignment. A series of 45 consecutive cases was performed using the MAKO Total Knee system and Triathlon Total Knee implant (Stryker) between April 2018 and May 2019. The difference between what was planned and what was achieved for bone resection and coronal limb alignment was calculated. A total of 37 patients had their data captured using the MAKO system software. Mean difference from the plan for distal femoral cuts was 0.38mm (0.32) deep/proud, anterior femoral cuts 0.44mm (0.27) deep/proud and tibial cuts 0.37mm (0.30) deep/proud. In total, 99 out of 105 (94.29%) of bone resections were within 1mm of the plan. Mean absolute difference in final limb coronal alignment was 0.78° (0.78), with 78.13% being ≤1.00° of the plan, and 100% being ≤3.00° of the plan. The accuracy in achieving preoperatively planned bone resection and final limb coronal alignment using the MAKO Total Knee system is high. Future research is planned to look at whether this is associated with decreased rates of polyethylene wear and revision arthroplasty.



Publication History

Received: 30 May 2019

Accepted: 17 September 2019

Article published online:
06 November 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Insall JN. Total knee replacement. In: Insall JN. ed. Surgery of the Knee. New York: Churchill Livingstone; 1984: 587-696
  • 2 Ritter MA, Davis KE, Meding JB, Pierson JL, Berend ME, Malinzak RA. The effect of alignment and BMI on failure of total knee replacement. J Bone Joint Surg Am 2011; 93 (17) 1588-1596
  • 3 Hadi M, Barlow T, Ahmed I, Dunbar M, McCulloch P, Griffin D. Does malalignment affect revision rate in total knee replacements: a systematic review of the literature. Springerplus 2015; 4: 835
  • 4 Hampp EL, Chughtai M, Scholl LY. et al. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision compared with manual techniques. J Knee Surg 2019; 32(3): 239-250
  • 5 Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Joint Surg Am 2016; 98 (08) 627-635
  • 6 Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. Bone Joint J 2018; 100-B (07) 930-937
  • 7 Biant LC, Yeoh K, Walker PM, Bruce WJ, Walsh WR. The accuracy of bone resections made during computer navigated total knee replacement. Do we resect what the computer plans we resect?. Knee 2008; 15 (03) 238-241
  • 8 Bäthis H, Perlick L, Tingart M, Perlick C, Lüring C, Grifka J. Intraoperative cutting errors in total knee arthroplasty. Arch Orthop Trauma Surg 2005; 125 (01) 16-20
  • 9 Fu J, Wang Y, Li X. et al. [Robot-assisted vs. conventional unicompartmental knee arthroplasty: systematic review and meta-analysis]. Orthopade 2018; 47 (12) 1009-1017
  • 10 Brooks PJ. Seven little cuts to the perfect TKA. Abstract in Orthopaedic Proceedings, BJJ 2018;100(10)
  • 11 Mannan A, Vun J, Lodge C, Eyre-Brook A, Jones S. Increased precision of coronal plane outcomes in robotic-assisted total knee arthroplasty: a systematic review and meta-analysis. Surgeon 2018; 16 (04) 237-244
  • 12 Brooks P. Seven Cuts to the Perfect Total Knee. Orthopedics 2009; 32 (09) 680-682