[Utility of robotic-assisted total knee arthroplasty in patients with an occupied femoral canal].

Abstract

Introduction: the presence of implants that occupy the femoral canal is frequent in patients undergoing ipsilateral total knee replacement (TKR). The use of electronic alignment and robotic assistance make intramedullary alignment unnecessary and could be adequate in situations with an occupied femoral canal (OFC).

Material and methods: we present a prospective cohort of 25 patients who underwent robotic alignment TKR and had prior ipsilateral surgery in the femur that resulted in occupied femoral canal.

Results: we had 21 female, four male patients, with an average age of 62 years. There were 14 left knees, and 11 right knees. Twenty-two patients had a hip arthroplasty and three had femur osteosynthesis. Alignment prior to surgery was 16 valgus knees (average 11°, 3-22°) and nine varus knees (average 9.5°, 0.5-18.5°). TKR alignment was five neutral (0° as measured with the robot), 11 valgus 1.3° (range 0.5-3.5°) and 8 varus 1.5° (range 0.5- 2.5°). The average preoperative WOMAC scores was 43 points, postoperative 14 points.

Conclusions: we present a cohort of patients with moderate to severe varus and valgus knee deformities with an occupied femoral canal that were electronic alignment during robot-assisted (RA) TKR without the use of an intramedullary alignment (IMA) rod. We conclude electronic alignment of TKR can be performed successfully in patients with occupied femoral canal.