Coronal Correction for Severe Deformity Using Robotic-Assisted Total Knee Arthroplasty

摘要

Although robotic-assisted total knee arthroplasty (TKA) has the potential to accurately reproduce neutral alignment, it is still unclear if this correction is attainable in patients who have severe varus or valgus deformities. Therefore, the purpose of this study was to assess a single surgeon's experience with correcting coronal deformities using the robotic-assisted TKA device. Specifically, we looked at correction of varying degrees of varus and valgus deformity in patients who underwent robotic arm-assisted TKA. A total of 330 robotic-assisted TKA cases performed by a single surgeon were analyzed. Preoperative CT scans were registered to the robotic-assisted software to create a three-dimensional rendering from which coronal alignment was measured. Postoperative coronal alignment measurements were taken in the operating room using the robotic-assisted device after trial component placement. The robotic-assisted device uses optical tracking from navigation probes placed on the distal femur and proximal tibia. The robotic-assisted software can register these probes as bony landmarks to measure coronal alignment in the distal plane of the femoral component and proximal plane of the tibial component. A total of 261 cases were of varus knees, 46 cases were of valgus knees, and 23 cases had 0 degrees preoperative alignment. Severe deformity was defined as 7 degrees or greater deformity. Preoperative neutral alignment was defined as 0 degrees, while postoperative neutral alignment was defined as 0 degrees 3 degrees. There were 129 patients with and initial severe varus and 7 patients with an initial severe valgus deformity of 7 degrees or greater. Patients were divided into varus or valgus cohorts, and analysis was performed on the overall cohort, as well as nonsevere (7 degrees) and severe (7 degrees or greater) deformity cohorts.