Robotic total knee arthroplasty: the accuracy of CT-based component placement.

Jens Decking, Christoph Theis, Tobias Achenbach, Edgar Roth, Bernhard Nafe, Anke Eckardt
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引用次数: 74

Abstract

Background: Accurate alignment of the components in total knee arthroplasty is important. By use of postoperative CT controls, we studied the ability of a robotic effector to accurately place and align total knee arthroplasty (TKA) components according to a purely CT-based preoperative plan.

Patients and methods: Robotic TKA was performed in 13 patients (6 men) with primary gonarthrosis. Locator screws were placed into femur and tibia under spinal anesthesia. A CT-scan including the femoral head, knee and ankle was performed. In the preoperative planning software, virtual components were positioned into the CT volume. In a second operation, the robot milled femur and tibia with a high-speed milling tool according to the preoperative plan. On the 10th day, CT controls were performed following the same protocol as preoperatively.

Results: The mean deviation of the postoperative from the preoperatively planned mechanical axis was 0.2 degrees (95% CI: -0.1 degrees to 0.5 degrees ). The accuracy of angular component placement in frontal, sagittal and transverse planes was within +/-1.2 degrees , and the accuracy of linear component placement in mediolateral, dorsoventral and caudocranial directions was within +/-1.1 mm.

Interpretation: Robotic TKA allows placement of components with unparalleled accuracy, but further development is mandatory to integrate soft-tissue balancing into the procedure and make it faster, easier and cheaper.

机器人全膝关节置换术:基于ct的部件放置的准确性。
背景:全膝关节置换术中假体的准确对齐是很重要的。通过使用术后CT对照,我们研究了机器人效应器根据纯粹基于CT的术前计划准确放置和排列全膝关节置换术(TKA)部件的能力。患者和方法:对13例原发性膝关节病患者(6例男性)进行机器人TKA。在脊髓麻醉下,将定位螺钉置入股骨和胫骨。ct扫描包括股骨头、膝盖和脚踝。在术前规划软件中,将虚拟部件定位到CT容积中。在第二次手术中,机器人根据术前计划用高速铣刀铣削股骨和胫骨。第10天,按照与术前相同的方案进行CT对照。结果:术后与术前计划机械轴的平均偏差为0.2度(95% CI: -0.1度至0.5度)。在正面、矢状面和横向平面的角度组件放置精度在+/-1.2度以内,在中外侧、背腹侧和尾颅方向的线性组件放置精度在+/-1.1 mm以内。解释:机器人TKA可以以无与伦比的精度放置组件,但进一步的发展是强制性的,将软组织平衡整合到程序中,使其更快、更容易、更便宜。
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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