An Hao-Ming, Wen Jia-Xin, Gu Wang, Chen Ji-Ying, Chai Wei, Li Rui
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China; School of Medicine, Nankai University, Tianjin, China; Chinese PLA Medical School, Beijing, China.
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China.
J Arthroplasty. 2024 Sep;39(9):2248-2253. doi: 10.1016/j.arth.2024.03.029. Epub 2024 Mar 18.
There is an increasing number of different brands of robotic total knee arthroplasty (TKA) systems. Most robotic TKA systems share the same coronal alignment, while the definitions of sagittal alignment vary. The purpose of this study was to investigate whether these discrepancies impact the sagittal alignment of the lower extremity.
A total of 72 lower extremity computed tomography scans were included in our study, and 3-dimensional models were obtained using software. A total of 7 brands of robotic TKA systems were included in the study. The lower extremity axes were defined based on the surgical guide for each implant. We also set the intramedullary axis as a reference to evaluate the discrepancies in sagittal alignment of each brand of robotic system.
On the femoral side, the axis definition was the same for all 7 robotic TKA systems. The robotic TKA axes showed a 2.41° (1.58°, 3.38°) deviation from the intramedullary axis. On the tibial side, the 7 robots had different axis definitions. The tibial mechanical axis of 6 of the TKA systems was more flexed than that of the intramedullary axis, which means the posterior tibial slope was decreased while the tibial mechanical axis of the remaining system was more extended.
The sagittal alignment of the lower extremity for 7 different brands of robotic TKA systems differed from each other and all deviated from the intramedullary axis. Surgeons should be aware of this discrepancy when using different brands of robotic TKA systems to avoid unexpected sagittal alignment and corresponding adverse clinical outcomes.
Level IV, Therapeutic Study.
机器人全膝关节置换术（TKA）系统的品牌数量日益增加。大多数机器人TKA系统在冠状面排列上相同，但矢状面排列的定义各不相同。本研究的目的是调查这些差异是否会影响下肢的矢状面排列。
我们的研究共纳入72例下肢计算机断层扫描，并使用软件获得三维模型。研究共纳入7个品牌的机器人TKA系统。下肢轴线根据每个植入物的手术导板进行定义。我们还将髓内轴线作为参考，以评估每个品牌机器人系统矢状面排列的差异。
在股骨侧，所有7个机器人TKA系统的轴线定义相同。机器人TKA轴线与髓内轴线的偏差为2.41°（1.58°，3.38°）。在胫骨侧，7个机器人的轴线定义不同。6个TKA系统的胫骨机械轴线比髓内轴线更屈曲，这意味着胫骨后倾坡度减小，而其余系统的胫骨机械轴线更伸展。
7个不同品牌的机器人TKA系统的下肢矢状面排列彼此不同，且均偏离髓内轴线。外科医生在使用不同品牌的机器人TKA系统时应意识到这种差异，以避免意外的矢状面排列和相应的不良临床结果。
IV级，治疗性研究。
