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J Knee Surg 2022; 35(14): 1549-1555
DOI: 10.1055/s-0041-1727115
Original Article

Robotic-Assisted Unicompartmental Knee Arthroplasty Reduces Components' Positioning Differences among High- and Low-Volume Surgeons

Fabrizio Matassi
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
,
Matteo Innocenti 
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
,
Niccolò Giabbani 
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
,
Giacomo Sani 
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
,
Andrea Cozzi Lepri
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
,
Nicola Piolanti
2   Orthopaedics and Traumatology Division, University of Pisa, Pisa, Italy
,
Roberto Civinini
1   Orthopaedic Clinic CTO, University of Florence, Florence, Italy
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Funding None.
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Abstract

Robotic-assisted medial unicompartmental knee arthroplasty (mUKA) has been introduced to improve accuracy in implant positioning and limb alignment, overcoming the reported high failure rates of conventional UKA. Indeed, mUKA is a technically challenging procedure strongly related to surgeons' skills and expertise. The purpose of this study was to evaluate the likelihood of robotic-assisted surgery in reducing the variability of coronal and sagittal component positioning between high- and low-volume surgeons. We evaluated a prospective cohort of 161 robotic mUKA implanted between May 2018 and December 2019 at two high-volume robotic centers. Patients were divided into two groups: patients operated by “high-volume” (group A) or “low-volume” (group B) surgeons. We recorded intraoperative lower-limb alignment, component positioning, and surgical timing. Postoperatively, every patient underwent a radiographical protocol to assess coronal and sagittal femoral/tibial component alignment. Range of motion and other clinical outcomes were assessed pre- and 12 months postoperatively by using oxford knee score, forgotten joint score, and visual analog scale. Of 161 recruited knees, 149 (A: 101; B: 48) were available for radiographic analysis at 1 month, and clinical evaluation at 12 months. No clinical difference neither difference in mechanical alignment nor coronal/sagittal component positioning were found (p > 0.05). A significant difference was recorded in surgical timing (A: 57 minutes; B: 86 minutes; p < 0.05). No superficial or deep infections or other major complications have been developed during the follow-up. Robotics surgery in mUKA confirmed its value in improving the reproducibility of such technical procedure, with satisfactory clinical outcomes. Moreover, it almost eliminates any possible differences in component positioning, and lower limb alignment among low-and high- volume knee surgeons.

Keywords

medial unicompartmental knee arthroplasty - robotic-assisted surgery - MAKOplasty - component positioning - high- and low-volume surgeons

Note

The study and follow-up, respecting the criteria of the Declaration of Helsinki, have been approved by the institutional review board of Azienda Ospedaliera Universitaria Careggi Department of Surgery and Translational Medicine. The Institutional Review Board accepted the proposal of the study, and all selected patients were properly informed before surgery about the treatment and follow-up visits after discharge. All patients accepted to have their data been published on a journal.


Authors' Contributions

M.I. and F.M. are the two authors who made both the conception and the design of the work as well as they drafted the first version of the work. Each author has made substantial contributions to the design of the work as well as to the acquisition, analysis, and interpretation of data. All authors have also substantively revised the work and have approved the submitted version (and any substantially modified version that involves the author's contribution to the study), and they have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.




Publikationsverlauf

Eingereicht: 24. November 2020

Angenommen: 12. Februar 2021

Artikel online veröffentlicht:
14. April 2021

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