Minimum reporting criteria for robotic assisted total knee arthroplasty studies: alignment and balancing techniques should both be defined

摘要

There is a growing body of evidence assessing the outcome of robotic assisted total knee arthroplasty (rTKA), however it is not clear whether there is any functional benefit when compared to conventional manual TKA.1-4 Robotic assisted TKA allows the surgeon to position the implant accurately, joint gap to be balanced, and results in less soft tissue damage compared to manual TKA.5-7 However, there remain numerous techniques of aligning the implant and how the joint space/pressure should be balanced.8-11 Alignment and balance are likely to be directly related to one another, as balance may not be maintained throughout a range of movement (ROM) if the implant is not positioned along the kinematic axis for that knee due to differential change in the ligament tension.12 However, there are numerous methods for alignment of the prothesis and it is not clear which is optimal.8 Even when alignment has been defined/achieved the method and definition of balancing the knee throughout a ROM is also variable with numerous techniques being described, and numerous definitions of ‘balance’.11 It is not always clearly stated in rTKA studies how the implant was aligned or how balance was achieved or defined.1,3 The authors suggest there should be a minimum reporting criterion for future rTKA studies to clearly define these methods to allow the results to be interpreted in context. Currently all data from rTKA studies are being amalgamated on the assumption of a homogeneous group of patients and this may not be the case.5,13 The authors propose that implant alignment and method of balancing the knee should be defined in all future rTKA studies.