Chandrashekar Anoop S, Fox Jacob A, Locascio Logan M, Polkowski Gregory G, Faschingbauer Martin, Martin J Ryan
Vanderbilt University School of Medicine Nashville Tennessee USA.
Department of Orthopaedic Surgery Vanderbilt University Medical Center Nashville Tennessee.
J Exp Orthop. 2025 Mar 18;12(1):e70220. doi: 10.1002/jeo2.70220. eCollection 2025 Jan.
This study sought to validate intraoperative robotic measurements of femoral and tibial component coronal alignment in total knee arthroplasty (TKA) by comparing to pre- and post-operative standing, double stance, long-leg radiographs (LLR).
This retrospective cohort study included 59 unique patients undergoing primary TKA at a single institution. Pre- and post-operative femoral and tibial coronal alignment were measured on LLRs using a deep learning artificial intelligence model and compared to measurements obtained from the imageless robotic system to evaluate the robot's accuracy and reliability.
Robotic measurements were highly correlated with measurements from preoperative LLR (Pearson = 0.68). There was no significant difference in preoperative constitutional alignment between the two methodologies (p = 0.28). Additionally, the intraoperative and post-operative alignment of femoral and tibial implants were not significantly different ( = 0.12 and = 0.95, respectively) and were strongly correlated (Pearson = 0.5 and Pearson = 0.6 respectively). The mean difference in femoral alignment was 0.43° and the mean difference in tibial alignment was 0.01°.
The findings of this study suggest that there were no significant differences in the coronal alignment of TKA when assessed by a robotic system compared to LLR. This signifies the robotic system's high intraoperative accuracy and reliability in determining coronal alignment.
Level III.
本研究旨在通过与术前和术后站立位、双足站立位、长腿X线片（LLR）进行比较，验证全膝关节置换术（TKA）中股骨和胫骨组件冠状面排列的术中机器人测量结果。
这项回顾性队列研究纳入了在单一机构接受初次TKA的59例独特患者。使用深度学习人工智能模型在LLR上测量术前和术后股骨和胫骨的冠状面排列，并与从无图像机器人系统获得的测量结果进行比较，以评估机器人的准确性和可靠性。
机器人测量结果与术前LLR测量结果高度相关（Pearson系数=0.68）。两种方法术前的结构排列无显著差异（p=0.28）。此外，股骨和胫骨植入物的术中与术后排列无显著差异（分别为=0.12和=0.95），且相关性很强（Pearson系数分别为0.5和0.6）。股骨排列的平均差异为0.43°，胫骨排列的平均差异为0.01°。
本研究结果表明，与LLR相比，通过机器人系统评估时，TKA的冠状面排列无显著差异。这表明机器人系统在确定冠状面排列方面具有较高的术中准确性和可靠性。
III级。
