Department of Orthopedics and Physical Rehabilitation
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Health Services Administration | Musculoskeletal Diseases | Orthopedics | Surgical Procedures, Operative
Objectives: The use of the haptically bounded saw blades in robotic-assisted total knee arthroplasty (RTKA) can potentially help to limit surrounding soft-tissue injuries. However, there are limited data characterizing these injuries for cruciate-retaining (CR) TKA with the use of this technique. The objective of this cadaver study was to compare the extent of soft-tissue damage sustained through a robotic-assisted, haptically guided TKA (RATKA) versus a manual TKA (MTKA) approach.
Methods: A total of 12 fresh-frozen pelvis-to-toe cadaver specimens were included. Four surgeons each prepared three RATKA and three MTKA specimens for cruciate-retaining TKAs. A RATKA was performed on one knee and a MTKA on the other. Postoperatively, two additional surgeons assessed and graded damage to 14 key anatomical structures in a blinded manner. Kruskal-Wallis hypothesis tests were performed to assess statistical differences in soft-tissue damage between RATKA and MTKA cases.
Results: Significantly less damage occurred to the PCLs in the RATKA versus the MTKA specimens (p < 0.001). RATKA specimens had non-significantly less damage to the deep medial collateral ligaments (p = 0.149), iliotibial bands (p = 0.580), poplitei (p = 0.248), and patellar ligaments (p = 0.317). The remaining anatomical structures had minimal soft-tissue damage in all MTKA and RATKA specimens.
Conclusion: The results of this study indicate that less soft-tissue damage may occur when utilizing RATKA compared with MTKA. These findings are likely due to the enhanced preoperative planning with the robotic software, the real-time intraoperative feedback, and the haptically bounded saw blade, all of which may help protect the surrounding soft tissues and ligaments.
Robotic-assisted arthroplasty, Total knee arthroplasty
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Copyright © 2019 Author(s) et al. Open access: This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/.
DOI of Published Version
Bone Joint Res. 2019 Nov 2;8(10):495-501. doi: 10.1302/2046-3758.810.BJR-2019-0129.R1. eCollection 2019 Oct.. Link to article on publisher's site
Bone and joint research
Hampp EL, Sodhi N, Scholl L, Deren ME, Yenna Z, Westrich G, Mont MA. (2019). Less iatrogenic soft-tissue damage utilizing robotic-assisted total knee arthroplasty when compared with a manual approach: A blinded assessment. Open Access Publications by UMass Chan Authors. https://doi.org/10.1302/2046-3758.810.BJR-2019-0129.R1. Retrieved from https://escholarship.umassmed.edu/oapubs/4051
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.