Correlation between functional outcome and alterations of aHKA, PCOR, and Caton-Deschamps index following image-based robotic TKA in varus knees

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-08-21 DOI:10.1016/j.jor.2025.08.037

Claudio Glowalla , Laura Fischer , Philipp Marius Stein , Sophia Hasenknopf , Heiko Graichen , Rüdiger von Eisenhart-Rothe

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Abstract

Purpose

This study evaluated the relationship between functional outcomes and radiographic parameter changes in coronal and sagittal planes after robotic-assisted TKA in varus knees.

Methods

Between May 2020 and December 2022, all patients who underwent robotic-assisted total knee arthroplasty (RaTKA) using Functional Alignment technique (Mako, Stryker) and met predefined inclusion and exclusion criteria were enrolled in this study. A total of 115 patients (mean age 69.7 years; BMI 27.9; ASA 2.1) with varus knee morphology (defined as an arithmetic hip-knee-ankle angle [aHKA] < 0°) and complete datasets were included in the final analysis.

For analysis pre- and postoperative full-length weight-bearing radiographs and lateral knee views were obtained, and the Medial Proximal Tibial Angle (MPTA) and mechanical Lateral Distal Femoral Angle (mLDFA) in the coronal plane, as well as the Posterior Condylar Offset Ratio (PCOR) and Caton-Deschamps -Index in the sagittal plane were assessed. Based on the differences between pre- and postoperative values of the key parameters, patients were classified into two groups: Collective A, showing no deviation from preoperative alignment, and collective B, exhibiting a deviation in at least one parameter according to predefined thresholds.

Clinical outcome, and patient satisfaction 2 months postoperatively using validated patient-reported outcome measures (PROMs) were compared between the collectives.

Results

No significant differences were observed between the collectives regarding demographics and preoperative clinical parameters. 47 patients were assigned to Collective A, 68 to Collective B. Collective A showed significantly better OKS (26.2 vs. 29.9; p = 0.037∗), EQ-VAS (75.0 vs. 67.2; p = 0.014∗), EQ-5D (0.87 vs. 0.80; p = 0.005∗), and ROM (+4.7° vs. −9.2°; p = 0,007∗), whereas FJS was non-significantly higher in A (44.5 vs. 34.1; p = 0.062).

Conclusion

Anatomic bony restoration in the coronal and sagittal plane was associated with better early outcomes. Even single-parameter deviations may impair results, underscoring the importance of accurate reconstruction in robotic TKA.

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基于图像的膝关节内翻机器人TKA后功能结局与aHKA、PCOR和卡顿-德尚指数改变的相关性

目的：本研究评估膝关节内翻机器人辅助TKA术后冠状面和矢状面影像学参数变化与功能预后的关系。方法：在2020年5月至2022年12月期间，所有使用功能对齐技术（Mako, Stryker）接受机器人辅助全膝关节置换术（RaTKA）并符合预定义的纳入和排除标准的患者纳入本研究。最终分析共纳入115例膝关节内翻形态（定义为髋关节-膝关节-踝关节算术角度[aHKA] <； 0°）的患者（平均年龄69.7岁，BMI 27.9, ASA 2.1）和完整的数据集。为了分析，我们获得了术前和术后的全身负重x线片和膝关节外侧视图，并评估了冠状面胫骨内侧近端角（MPTA）和机械股骨外侧远端角（mLDFA），以及矢状面后髁偏移比（PCOR）和卡顿-德尚指数。根据关键参数术前与术后值的差异，将患者分为两组：A组，与术前对齐无偏差；B组，根据预定义阈值至少有一个参数偏差。采用有效的患者报告结果测量（PROMs）对两组患者的临床结果和术后2个月的患者满意度进行比较。结果两组患者在人口统计学和术前临床参数上无显著差异。47名患者被分配到A组，68名患者被分配到b组。A组的OKS （26.2 vs. 29.9; p = 0.037∗）、EQ-VAS （75.0 vs. 67.2; p = 0.014∗）、EQ-5D （0.87 vs. 0.80; p = 0.005∗）和ROM（+4.7°vs. - 9.2°；p = 0.007∗）明显更好，而A组的FJS无显著性升高（44.5 vs. 34.1; p = 0.062）。结论冠状面和矢状面解剖骨修复具有较好的早期预后。即使是单一参数的偏差也可能影响结果，强调了准确重建机器人TKA的重要性。

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 orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.