Tibial implant varus >3° does not adversely affect outcomes or revision rates in functionally aligned image-based robotic total knee arthroplasty in a minimum of 2-year follow-up.
{"title":"Tibial implant varus >3° does not adversely affect outcomes or revision rates in functionally aligned image-based robotic total knee arthroplasty in a minimum of 2-year follow-up.","authors":"Christos Koutserimpas, Riccardo Garibaldi, Flora Olivier, Elvire Servien, Cécile Batailler, Sébastien Lustig","doi":"10.1002/ksa.12659","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Functional alignment (FA) aims to restore knee kinematics by balancing laxities and adapting implant positioning. This study evaluates safety and outcomes of >3° varus tibial positioning in patients with varus deformity undergoing robotic-assisted total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>This retrospective study included 337 patients with varus deformity undergoing robotic-assisted TKA with FA principles with a minimum of 2-year follow-up. Patients were divided into two groups based on tibial varus positioning: ≤3° varus: Group A and >3° varus: Group B. Preoperative and postoperative coronal alignment, implant positioning, and outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score (FJS) at final follow-up. The primary outcome was implants' survivorship, and secondary outcomes included complication rates and functional scores. Statistical analyses included Mann-Whitney and Chi-square tests for group comparisons, Kaplan-Meier survival analysis for implant survivorship, and multivariate regression for key covariates.</p><p><strong>Results: </strong>Implant survivorship was 99.4% in Group B over a median follow-up of 30 months, with one revision due to aseptic loosening and 100% in Group A (p = 0.36). The overall complication rates were 12.7% in Group A and 10.2% in B (p = 0.48). The median KSS-knee and function scores were 94.5 and 90 in Group A and 94 and 90 in B (p = 0.88 and 0.8, respectively). The final FJS was 82 in Group A and 84 in B (p = 0.8). No significant differences were observed in postoperative knee range of motion between the two groups. Multivariate regression analysis showed that none of the included covariates were statistically significant predictors of implant failure.</p><p><strong>Conclusion: </strong>FA in robotic-assisted TKA with tibial positioning >3° varus seems to be safe and reliable in patients with varus deformity, demonstrating similar revision rates, implant survivorship, and outcomes compared to the ≤3° tibial varus group.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12659","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Functional alignment (FA) aims to restore knee kinematics by balancing laxities and adapting implant positioning. This study evaluates safety and outcomes of >3° varus tibial positioning in patients with varus deformity undergoing robotic-assisted total knee arthroplasty (TKA).
Methods: This retrospective study included 337 patients with varus deformity undergoing robotic-assisted TKA with FA principles with a minimum of 2-year follow-up. Patients were divided into two groups based on tibial varus positioning: ≤3° varus: Group A and >3° varus: Group B. Preoperative and postoperative coronal alignment, implant positioning, and outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score (FJS) at final follow-up. The primary outcome was implants' survivorship, and secondary outcomes included complication rates and functional scores. Statistical analyses included Mann-Whitney and Chi-square tests for group comparisons, Kaplan-Meier survival analysis for implant survivorship, and multivariate regression for key covariates.
Results: Implant survivorship was 99.4% in Group B over a median follow-up of 30 months, with one revision due to aseptic loosening and 100% in Group A (p = 0.36). The overall complication rates were 12.7% in Group A and 10.2% in B (p = 0.48). The median KSS-knee and function scores were 94.5 and 90 in Group A and 94 and 90 in B (p = 0.88 and 0.8, respectively). The final FJS was 82 in Group A and 84 in B (p = 0.8). No significant differences were observed in postoperative knee range of motion between the two groups. Multivariate regression analysis showed that none of the included covariates were statistically significant predictors of implant failure.
Conclusion: FA in robotic-assisted TKA with tibial positioning >3° varus seems to be safe and reliable in patients with varus deformity, demonstrating similar revision rates, implant survivorship, and outcomes compared to the ≤3° tibial varus group.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
