The utility of robotic-assisted surgery in total knee arthroplasty for moderate and severe valgus deformities: a case series.

Abstract

Background: Achieving soft tissue balance is challenging in valgus arthritic knee because of a combination of anomalies in the soft tissues and bones. It has been stipulated that contemporary robotic systems are more precise than traditional instrumentation. Its advantage lies in the soft tissue algorithms. Presently, there is paucity of information on the use of robotic-assisted TKA in addressing moderate and severe valgus deformities. The aim of this series is to demonstrate the utility of robotic-assisted surgery in TKA for arthritic knees with moderate and severe valgus deformities, including accuracy, soft tissue releases performed and level of constraint required.

Methods: This is a single surgeon series of 14 cases of moderate and severe valgus osteoarthritic knees who underwent robotic-assisted TKA, utilizing the robotic surgical assistant ROSA^® System.

Results: All patients were restored to within 3° of the planned alignment. 8 patients were implanted with cruciate retaining implants, 2 had ultracongruent implants, 3 had posterior stabilized implants, and 1 had a constrained posterior stabilized implant. No patients required release of the popliteus tendon or origin of the lateral collateral ligament. No perioperative complications were encountered in all cases. All patients reported an improvement in the Forgotten Joint Score of > 10.8 at 1year follow up with a 100% satisfaction rate.

Conclusion: In this case series, the utilization of robotic assisted the surgeon to achieve a final limb alignment to within 3° of the planned alignment with minimal use of constrained prostheses and good patient-reported outcomes in moderate and severe valgus deformities.