Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2021
Health economic value of CT scan based robotic assisted UKA: a systematic review of comparative studies.
The aim of this systematic review was to compare relevant health economic consequences of the CT-based robotic-arm-assisted system versus conventional Uni-compartmental Knee Arthroplasty (UKA). ⋯ Systematic review, Level IV.
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Arch Orthop Trauma Surg · Dec 2021
Immersive technologies for total knee arthroplasty surgical education.
The need to adapt surgical curricula to meet the demands of an increasingly restrictive training environment is rising. Modern constraints of surgical trainees including work-hour restrictions and concerns surrounding patient safety have created an opportunity to supplement traditional teaching methods with developing immersive technologies including virtual and augmented reality. Virtual reality (VR) and augmented reality (AR) have been preliminarily investigated as it relates to total joint arthroplasty. The purpose of this article is to discuss VR and AR as it applies to modern total knee replacement (TKR) surgical education.
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Arch Orthop Trauma Surg · Dec 2021
Joint line is restored in robotic-arm-assisted total knee arthroplasty performed with a tibia-based functional alignment.
Functional alignment (FA) in total knee arthroplasty (TKA) has been introduced to restore the native joint line obliquity, respect the joint line height and minimize the need of soft tissue releases. The purpose of this study was to assess the intraoperative joint line alignment and compare it with the preoperative epiphyseal orientation of the femur and tibia in patients undergoing robotic-arm-assisted (RA)-TKA using FA. ⋯ The proposed robotic-assisted functional technique for TKA alignment, with a restricted tibial component coronal alignment, based on the preoperative phenotype and femoral component positioning as dictated by the soft tissues, provided joint line respecting resections. Further studies are needed to assess long-term implant survivorship, patient satisfaction and alignment-related failures.
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Arch Orthop Trauma Surg · Dec 2021
An insert with less than spherical medial conformity causes a loss of passive internal rotation after calipered kinematically aligned TKA.
In total knee arthroplasty (TKA), the level of conformity, a medial stabilized (MS) implant, needs to restore native (i.e., healthy) knee kinematics without over-tensioning the flexion space when the surgeon chooses to retain the posterior cruciate ligament (PCL) is unknown. Whether an insert with a medial ball-in-socket conformity and lateral flat surface like the native knee or a less than spherical medial conformity restores higher and closer to native internal tibial rotation without anterior lift-off, an over-tension indicator, when implanted with calipered kinematic alignment (KA), is unknown. ⋯ An MS insert with a medial ball-in-socket and lateral flat surface that matches the native knee's spherical conformity restores native tibial internal rotation when implanted with calipered KA and PCL retention without over-tensioning the flexion space.
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Arch Orthop Trauma Surg · Dec 2021
Imageless robotic handpiece-assisted total knee arthroplasty: a learning curve analysis of surgical time and alignment accuracy.
Robotic-assisted surgery techniques are increasing in total knee arthroplasty (TKA). One crucial point is the prolonged time of surgery. The primary objective of this study was to determine the learning curve necessary to minimize the time of surgery. The secondary objective was to evaluate the accuracy of the implant alignment when using an imageless robotic system for TKA. ⋯ After completing the initial learning curve of 11 cases, the surgery time required to perform imageless robotic handpiece-assisted TKA was similar to that for the conventional technique. However, no learning curve was observed for the implant positioning when using the imageless robotic system. The implementation of the intraoperative plan was accurate up to < 2°. The precision of the system allows the implementation of different joint balancing approaches between valgus and varus morphotypes.