Femoral components are positioned in greater external rotation using functional alignment in robot-assisted total knee arthroplasty compared to mechanical alignment

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-07-21 DOI:10.1002/jeo2.70362

Anne Ruth van Meijeren, Danielle Langeloo, Hans-Peter van Jonbergen, Marrigje Meijer

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Abstract

Purpose

Objective of this study was to evaluate the effect of functional alignment on femoral component rotation compared to mechanical alignment in knees with a constitutional tibial varus alignment classified as coronal plane alignment of the knee (CPAK) types I, II and IV.

Methods

This retrospective study included patients undergoing conventional total knee replacement (TKR) (n = 64) and robot-assisted TKR (n = 84). Coronal and axial measurements were performed manually and automatically using pre- and postoperative computed tomography images in the conventional group and robot-assisted group respectively.

Results

Femoral component rotation was statistically significant more external rotated in the conventional group versus robot-assisted group (1.3° ± 2.7° vs. 0.76° ± 1.4°, p < 0.001). Also, the tibial plateau was placed statistically significant more in varus in the robot-assisted group compared to the conventional group (87.6° ± 2.5° vs. 88.9° ± 1.4°, p < 0.001).

Conclusion

Functional alignment leads to more varus of the tibial component and less external rotation of the femoral component compared to mechanical alignment in TKR in patients with a constitutional tibial varus alignment. Since this is a radiological analysis, further research is needed to understand how these differences affect clinical outcomes as faster recovery, adequate patellar tracking and longer survival.

Level of Evidence

Level III.

Abstract Image

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与机械对齐相比，在机器人辅助全膝关节置换术中，使用功能对齐将股骨假体定位在更大的外旋位置

目的：本研究的目的是评估功能性对齐对股骨假体旋转的影响，比较膝关节机械对齐与成型性胫骨内翻对齐（CPAK） I型冠状面对齐的影响。方法回顾性研究包括64例常规全膝关节置换术（TKR）患者和84例机器人辅助全膝关节置换术（TKR）患者。在常规组和机器人辅助组分别使用术前和术后计算机断层扫描图像手动和自动进行冠状和轴向测量。结果：与机器人辅助组相比，常规组股骨假体的外旋有统计学意义（1.3°±2.7°比0.76°±1.4°，p < 0.001）。此外，与常规组相比，机器人辅助组胫骨平台内翻的发生率有统计学意义（87.6°±2.5°比88.9°±1.4°，p < 0.001）。结论与机械式胫骨内翻对准相比，功能性对准可导致TKR患者胫骨内翻增加，股骨外旋减少。由于这是一项放射学分析，需要进一步的研究来了解这些差异如何影响临床结果，如更快的恢复，足够的髌骨跟踪和更长的生存期。证据等级三级。

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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