Duchniewicz Michał A, Shaaban Aly, Müller Manuel, Anderson Philip M, Goebel Lars, Orth Patrick, Wolf Milan A, Bachelier Felix, Landgraeber Stefan, Winter Philipp
Department of Orthopaedic Surgery, University of Saarland, 66421 Homburg, Germany.
School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK.
J Clin Med. 2025 Mar 3;14(5):1698. doi: 10.3390/jcm14051698.
Robotic assistance is considered capable of improving precision and outcomes of total knee replacement. We assessed the inherent biases, pre-procedural planning accuracy using 2D to 3D X-Atlas, and final knee axis outcomes of the ROSA Knee System (Zimmer Biomet, Warsaw, IN, USA). A total of 55 patients who underwent robotic-assisted knee replacement using ROSA Knee System (Zimmer Biomet, Warsaw, IN, USA) at a single center were included. Pre-procedural measurements performed by ROSA were compared to those performed by senior consultants. Component sizes predicted by ROSA were compared to those implanted. A final axis measurement was taken during the procedure. Femur components were exactly matched in (83.64%) cases, accurately matched in a further 8 (14.55%), and inaccurately matched for only 1 (1.82%). Tibial component sizes were exactly matched by the planning for 39 (70.91%), accurately for 12 (21.82%), and inaccurately for 4 (7.27%). ANOVA did not show statistically significant differences between the predicted and implanted femur ( = 0.96) nor the tibia components ( = 0.27). We show that ROSA pre-procedural planning has a statistically significant bias ( = 0.001), with a deviation of 0.83 degrees into varus, when assessing the knee axis in the coronal plane, compared to senior consultant measurements. The average of the final coronal knee axis was 0.37 degrees in varus (SD = 2.49). ROSA accurately predicts implanted component sizes. Despite the small and statistically significant varus bias in initial knee axis assessment, the system results lay within the ±3° of neutral knee axis, which is the widely accepted knee replacement standard.
机器人辅助被认为能够提高全膝关节置换的精度和效果。我们评估了ROSA膝关节系统（美国印第安纳州华沙市的捷迈邦美公司）的固有偏差、使用二维到三维X-Atlas进行的术前规划准确性以及最终的膝关节轴线结果。纳入了在单一中心使用ROSA膝关节系统（美国印第安纳州华沙市的捷迈邦美公司）接受机器人辅助膝关节置换的55例患者。将ROSA进行的术前测量与高级顾问进行的测量进行比较。将ROSA预测的假体尺寸与植入的假体尺寸进行比较。在手术过程中进行最终的轴线测量。股骨假体在83.64%的病例中完全匹配，另有8例（14.55%）准确匹配，只有1例（1.82%）匹配不准确。胫骨假体尺寸通过规划完全匹配的有39例（70.91%），准确匹配的有12例（21.82%），不准确匹配的有4例（7.27%）。方差分析未显示预测的股骨假体与植入的股骨假体（P = 0.96）以及胫骨假体（P = 0.27）之间存在统计学显著差异。我们发现，与高级顾问的测量相比，在评估冠状面膝关节轴线时，ROSA术前规划存在统计学显著偏差（P = 0.001），内翻偏差为0.83度。最终冠状面膝关节轴线的平均值为内翻0.37度（标准差 = 2.49）。ROSA能够准确预测植入的假体尺寸。尽管在初始膝关节轴线评估中存在小的且具有统计学显著性的内翻偏差，但该系统的结果仍在中立膝关节轴线±3°范围内，这是广泛接受的膝关节置换标准。
