Zaidi Faseeh, Goplen Craig M, Fitz-Gerald Connor, Bolam Scott M, Hanlon Michael, Munro Jacob T, Monk Andrew P
Department of Surgery, University of Auckland, Auckland, New Zealand.
Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Knee Surg Sports Traumatol Arthrosc. 2025 Jan;33(1):229-238. doi: 10.1002/ksa.12272. Epub 2024 May 20.
Robotic-assisted total knee arthroplasty (TKA) has been shown to improve the accuracy and precision of bony resections and implant position. However, the in vivo accuracy of the full surgical workflow has not been widely reported. The primary objective of this study is to determine the accuracy and precision of a robotic-arm-assisted system throughout the intraoperative workflow.
This was a retrospective cohort study of adult patients who underwent primary TKA with various workflows and alignment targets by three arthroplasty-trained surgeons with previous experience using the ROSA® Knee System (Zimmer Biomet) over a 3-month follow-up period. Accuracy and precision were determined by measuring the difference between various workflow time points, including the final preoperative plan (PP), robot-validated (RV) resection angle and postoperative radiographs (PR). The absolute mean difference between the measurements determined accuracy, and the standard deviation represented precision. The lateral distal femoral angle, medial proximal tibial angle, femoral flexion angle and tibial slope were measured on postoperative coronal long-leg radiographs and true short-leg lateral radiographs.
A total of 77 patients were included in the final analyses. The accuracy for the coronal femoral angle was 1.62 ± 1.11°, 0.75 ± 0.79° and 1.96 ± 1.29° for the differences between PP and PR, PP and RV and RV and PR. The tibial coronal accuracy was 1.44 ± 1.03°, 0.81 ± 0.67° and 1.57 ± 1.14° for PP/PR, PP/RV and RV/PR, respectively. Femoral flexion accuracy was 1.39 ± 1.05°, 0.83 ± 0.59° and 1.81 ± 1.21° for PP/PR, PP/RV and RV/PR, respectively. Tibial slope accuracy was 0.99 ± 0.72°, 1.19 ± 0.87° and 1.63 ± 1.11°, respectively. The proportion of patients within 3° was 93.2%, 95.3%, 97.3% and 94.6% for the distal femur, proximal tibia, femoral flexion and tibial slope angles when the final intraoperative plan was compared to PRs. No patients had a postoperative complication at the final follow-up.
The ROSA Knee System has acceptable accuracy and precision of coronal and sagittal plane resections with few outliers at various steps throughout the platform's entire workflow in vivo.
Level III.
机器人辅助全膝关节置换术（TKA）已被证明可提高骨切除和植入物放置的准确性和精确性。然而，完整手术流程的体内准确性尚未得到广泛报道。本研究的主要目的是确定机器人手臂辅助系统在整个术中流程中的准确性和精确性。
这是一项回顾性队列研究，研究对象为成年患者，他们接受了由三位接受过关节置换培训、有使用ROSA®膝关节系统（捷迈邦美）经验的外科医生采用不同手术流程和对线目标进行的初次TKA手术，并进行了3个月的随访。通过测量不同手术流程时间点之间的差异来确定准确性和精确性，这些时间点包括最终术前计划（PP）、机器人验证（RV）切除角度和术后X线片（PR）。测量值之间的绝对平均差异确定准确性，标准差表示精确性。在术后冠状位长腿X线片和真正的短腿侧位X线片上测量股骨远端外侧角、胫骨近端内侧角、股骨屈曲角度和胫骨坡度。
最终分析共纳入77例患者。对于冠状位股骨角度，PP与PR、PP与RV、RV与PR之间差异的准确性分别为1.62±1.11°、0.75±0.79°和1.96±1.29°。胫骨冠状位准确性方面，PP/PR、PP/RV和RV/PR分别为1.44±1.03°、0.81±0.67°和1.57±1.14°。股骨屈曲准确性方面，PP/PR、PP/RV和RV/PR分别为1.39±1.05°、0.83±0.59°和1.81±1.21°。胫骨坡度准确性分别为0.99±0.72°、1.19±0.87°和1.63±1.11°。将最终术中计划与PRs比较时，股骨远端、胫骨近端、股骨屈曲和胫骨坡度角度在3°范围内的患者比例分别为93.2%、95.3%、97.3%和94.6%。在最终随访时，没有患者出现术后并发症。
ROSA膝关节系统在体内整个平台的整个工作流程的各个步骤中，冠状面和矢状面切除具有可接受的准确性和精确性，异常值较少。
三级。
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