Robot-assisted total knee arthroplasty using modified sub-vastus approach: A series of 120 knees

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-29 DOI:10.1016/j.jcot.2025.103078

B.N. Prashanth, Karthik Sangani, Yeshwanth M. Reddy

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引用次数: 0

Abstract

Background

The application of the Sub-vastus (SV) approach in Robot-assisted total knee arthroplasty (RATKA) is a relatively new practice with many potential benefits. This study aimed to assess the cases that underwent robot-assisted knee replacement through the sub-vastus approach, using functional and clinical parameters.

Methods

This monocentric, single-surgeon, retrospective observational study included 81 consecutive cases (120 knees) who had undergone Robot-assisted total knee arthroplasty with the Sub-vastus approach. Their Postoperative evaluation included hemoglobin levels, functional outcomes like the straight leg raising test (SLRT), walking ability, and the Oxford Knee Score (OKS).

Results

The average age of participants was 63.3 years. The mean hospital stay was 3.4 days (median 3 days). Perioperative drop in Hemoglobin concentration averaged 1.27 g/dl for unilateral and 1.5 g/dl for bilateral cases. By the second postoperative day, 85 % of the study group were able to perform active straight leg raising and 66 % were able to walk with support. These numbers increased to 95 % by the third day. The mean OKS was 45.832 (SD: 1.29).

Conclusion

The SV approach, when combined with RATKA, can yield improved functional results by showing the short-term benefits of a quadriceps-sparing technique, like less blood loss, faster recovery, and shorter hospital stay, while also enhancing surgical precision and accuracy in implant placement, thereby improving longevity. This combination is also effective in addressing severe deformities and obese cases, which previously were a limitation of the SV approach. Incorporating an oblique under-vastus release of the suprapatellar pouch and capsule was found to facilitate surgical access and may enhance procedural efficiency.

查看原文本刊更多论文

采用改良股下入路的机器人辅助全膝关节置换术：120个膝关节

在机器人辅助全膝关节置换术（RATKA）中应用股下（SV）入路是一项相对较新的实践，具有许多潜在的益处。本研究旨在评估通过股下入路进行机器人辅助膝关节置换术的病例，使用功能和临床参数。方法本研究为单中心、单外科医生、回顾性观察性研究，纳入了81例（120个膝关节）经股下入路机器人辅助全膝关节置换术。他们的术后评估包括血红蛋白水平、功能结果，如直腿抬高试验（SLRT）、行走能力和牛津膝关节评分（OKS）。结果参与者平均年龄63.3岁。平均住院时间3.4天（中位3天）。单侧患者围手术期血红蛋白平均下降1.27 g/dl，双侧患者平均下降1.5 g/dl。到术后第二天，85%的研究组患者能够主动抬高直腿，66%的患者能够在辅助下行走。到第三天，这些数字增加到95%。平均OKS为45.832 （SD: 1.29）。结论SV入路与RATKA联合使用时，可以通过显示保留股四头肌技术的短期优势，如更少的失血、更快的恢复和更短的住院时间，从而改善功能结果，同时还提高了植入物的手术精度和准确性，从而延长了寿命。这种组合在解决严重畸形和肥胖病例方面也很有效，这在以前是SV方法的局限性。合并髌上囊和囊的斜股下释放有助于手术进入，并可提高手术效率。

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

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.