Robotic total knee arthroplasty for moderate to high-grade valgus knee deformity: technique and outcomes.

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-03-04 DOI:10.1051/sicotj/2025005
Kanukuntla Kalyan, Ashish Singh, Purushotam Kumar, Akash Chandrashekar Gundalli, Sudhir Shankar Mane, Himanshu Swarnkar, Lavanya Singh
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引用次数: 0

Abstract

Introduction: Although the surgical techniques and functional outcomes of conventional total knee arthroplasty (TKA) are well-established, there is limited data available on robotic arm-assisted TKA (RATKA) in the context of valgus knee arthroplasty. The purpose of this study is to assess the efficacy of RATKA in the correction of moderate to severe valgus knee deformities using minimally constrained implants and to evaluate the short-term functional outcomes associated with this technique.

Methods: This prospective study was conducted on patients with moderate to severe grade valgus knee deformity who underwent RATKA from August 1, 2020 to May 31, 2022. Of 873 primary RATKA cases, 48 cases had valgus knee deformities. Among these, 27 had grade 2-3 valgus with intact medial collateral ligament (MCL), two had grade 3 valgus with incompetent MCL, 14 had grade 1 valgus, and five had post-traumatic valgus deformities. Over a two-year follow-up period, functional outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS), and complications were documented; however, radiological outcomes were not analyzed.

Results: Among 27 patients with Grade 2-3 valgus, the final cohort included 21 patients (24 knees). The mean age was 58.33 ± 9.63 years and 70.8% were female. Ten (41.7%) patients had rheumatoid arthritis and 14 (58.3%) had degenerative osteoarthritis (OA). The median surgical time was 68.00 (13.00) minutes, and the median blood loss was 478.45 (176.25) mL. The valgus grade was reduced from a baseline value of 22.43 ± 7.05 degrees to 5.26 ± 1.53 degrees at 6 weeks. The WOMAC scores improved from 67.58 ± 7.27 at baseline to 1.38 ± 0.57 in the second year post-operatively. Similarly, the KSS scores improved from 26.67 ± 10.34 at baseline to 181.96 ± 7.20 in the second year. One patient sustained a Type II supracondylar femur fracture after a fall, managed with distal femur arthroplasty, while another had delayed tibia pin tract healing, treated with antibiotics and dressings.

Conclusion: RATKA facilitates precise correction of moderate to severe valgus deformity through enhanced surgical planning and execution, achieving adequate functional outcomes with minimal complications through the application of functional alignment philosophy.

机器人全膝关节置换术治疗中度至高度外翻膝关节畸形:技术和结果。
导论:尽管传统全膝关节置换术(TKA)的手术技术和功能结果已经完善,但在外翻膝关节置换术中,机械臂辅助全膝关节置换术(RATKA)的数据有限。本研究的目的是评估RATKA在使用最小约束植入物矫正中度至重度外翻膝关节畸形中的疗效,并评估与该技术相关的短期功能结果。方法:本前瞻性研究对2020年8月1日至2022年5月31日行RATKA手术的中重度外翻膝关节畸形患者进行研究。在873例原发性RATKA病例中,48例有外翻膝关节畸形。其中2-3级外翻伴完整内侧副韧带(MCL) 27例,3级外翻伴不全内侧副韧带2例,1级外翻14例,外翻后外翻畸形5例。在两年的随访期间,使用西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)和膝关节社会评分(KSS)评估功能结果,并记录并发症;然而,没有分析放射学结果。结果:在27例2-3级外翻患者中,最终队列包括21例患者(24个膝关节)。平均年龄58.33±9.63岁,女性占70.8%。类风湿关节炎10例(41.7%),退行性骨关节炎14例(58.3%)。手术时间中位数为68.00(13.00)分钟,出血量中位数为478.45 (176.25)mL。6周时外翻度从基线值22.43±7.05度降至5.26±1.53度。WOMAC评分从基线时的67.58±7.27分提高到术后第二年的1.38±0.57分。同样,KSS评分从基线时的26.67±10.34分提高到第二年的181.96±7.20分。一名患者在跌倒后发生II型股骨髁上骨折,采用股骨远端关节置换术治疗,而另一名患者使用抗生素和敷料治疗,延迟了胫骨钉束愈合。结论:RATKA通过加强手术计划和执行,促进了中重度外翻畸形的精确矫正,通过应用功能对准理念,实现了足够的功能结果和最小的并发症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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