Evaluating the accuracy of Cuvis™ robot assisted total knee arthroplasty using offset type tensor system in ligament gap balancing

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-09 DOI:10.1016/j.jcot.2025.103095

Woon-Hwa Jung, Minseok Seo, Vaibhav Sahu, Jignesh Tandel

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引用次数: 0

Abstract

Background

Conventional total knee arthroplasty (TKA) is a widely accepted and cost effective procedure for treating symptomatic knee osteoarthritis. Despite its success, patient satisfaction rates range from 82 % to 89 %, primarily due to suboptimal functional outcomes, reduced implant longevity, and the need for revision surgeries stemming from component malalignment or soft tissue instability. Robot-assisted total knee arthroplasty (RA-TKA) offers a promising approach to address these challenges.

Aim

This study aims to evaluate the accuracy of robot-assisted total knee arthroplasty in achieving optimal ligament gap balancing, based on 159 cases performed in 2023.

Method

A total of 159 RA-TKA procedures using the Cuvis™ robot were conducted in 2023, with 9 valgus knees and 150 varus knees. Ligament gaps were measured twice by the robotic system: initially before bone cuts and subsequently after bone cuts. During surgery, an off-set type tensor was used to reassess ligament gaps. Cases exhibiting a discrepancy greater than 3 mm between extension and flexion gaps, as measured by both the tensor and robot, were included for further analysis. Discrepancies between surgeon-measured values and robot-predicted values were also evaluated.

Result

Of the 159 cases, 35 demonstrated a ligament gap discrepancy of more than 3 mm, as measured by the tensor. Among these, 24 cases (15 %) exhibited discrepancies between robotic measurements and tensor assessments. All 9 valgus knee cases showed discrepancies, while 15 varus knee cases also displayed discrepancies. The robot recorded 20 errors in ligament gap measurement, 2 errors in balancing, and 2 cases with both errors.

Conclusion

While robot-assisted TKA excels in bone cutting accuracy, errors in predicting ligament balancing and gaps remain in some cases. Therefore, caution is advised when adapting surgical strategies intra-operatively, relying solely on the Cuvis™ robotic system's measurements.

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利用偏移式张量系统平衡韧带间隙评估Cuvis™机器人辅助全膝关节置换术的准确性

背景：传统的全膝关节置换术（TKA）是一种被广泛接受且经济有效的治疗症状性膝骨关节炎的方法。尽管取得了成功，但患者的满意度从82%到89%不等，主要原因是功能结果不理想，种植体寿命缩短，以及由于部件错位或软组织不稳定而需要进行翻修手术。机器人辅助全膝关节置换术（RA-TKA）为解决这些挑战提供了一种很有前途的方法。目的本研究旨在评估机器人辅助全膝关节置换术实现最佳韧带间隙平衡的准确性，基于2023年进行的159例手术。方法在2023年使用Cuvis™机器人共进行159例RA-TKA手术，其中9例膝关节外翻，150例膝关节内翻。机器人系统测量了两次韧带间隙：第一次是在骨头切割之前，第二次是在骨头切割之后。手术中，使用偏移型张量仪重新评估韧带间隙。由张量器和机器人测量的伸展和屈曲间隙差异大于3mm的病例被纳入进一步分析。还评估了外科医生测量值与机器人预测值之间的差异。结果159例患者中，35例韧带间隙差大于3mm。其中，24例（15%）表现出机器人测量和张量评估之间的差异。9例膝外翻均有差异，15例膝内翻也有差异。机器人记录了韧带间隙测量误差20例，平衡误差2例，两种误差均有2例。结论虽然机器人辅助TKA在切骨准确性方面表现优异，但在预测韧带平衡和间隙方面仍存在一些误差。因此，在术中仅依靠Cuvis™机器人系统测量时，应谨慎采用手术策略。

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.