Does preoperative 3D CT planning helps in predicting the component size determination and alignment in automatic robotic total knee arthroplasty (RA-TKA)

Pramod Bhor; Sawankumar Pawar; Dnyanada Kutumbe; Arvind Vatkar; Sachin Kale; Rahul Jagtap

doi:10.1016/j.jor.2023.07.011

Does preoperative 3D CT planning helps in predicting the component size determination and alignment in automatic robotic total knee arthroplasty (RA-TKA)

J Orthop. 2023 Jul 23:43:25-29. doi: 10.1016/j.jor.2023.07.011. eCollection 2023 Sep.

Authors

Pramod Bhor¹, Sawankumar Pawar¹, Dnyanada Kutumbe¹, Arvind Vatkar¹, Sachin Kale¹, Rahul Jagtap¹

Affiliation

¹ Fortis Hiranandani Hospitals, Mini Sea Shore Road, Juhu Nagar, Sector 10A, Vashi, Navi Mumbai, Maharashtra, 400703, India.

PMID: 37555200
PMCID: PMC10405159 (available on 2024-09-01)
DOI: 10.1016/j.jor.2023.07.011

Abstract

Purpose: Image-based Robotic Total knee Arthroplasty (RA-TKA)was developed with the purpose of enhancing the accuracy in determining the component sizes preoperatively and helping surgeons in minimizing errors and improve patient outcomes. The research aims to find the reliability of robotic-assisted TKR based on images in determining the correct component sizes using preoperative three-dimensional (3D) computer tomography.

Method: After ethical approval, we conducted a prospective study from March 2022 to December 2022. A total of 100 knees underwent image-based RA-TKA having grade 4 Osteoarthritis knee (Kellegren Lawrence classification). A single senior surgeon performed on all patients. Postoperative implant sizes and fit were assessed by five radiographic markers by an independent observer.

Results: In our study, we found the mean age was (64.96 ± 7.3) years, with female to male ratio of 43:22. The preoperative 3D CT accuracy is 100% for femoral component sizing and 97% for the tibial component. There was a statistically significant improvement in varus deformity from preoperative 7.370 ± 3.70° to 1.24 0 ± 0.910° after surgery., p = 0.001. Improvement in flexion deformity correction was from preoperative 6.50 ± 6.30 to postoperative 1.640 ± 1.770, p = 0.001.

Conclusion: Our study concludes that the use of pre-operative 3D CT helps in predicting the component sizes, minimizes surgical time, and enhances implant position accuracy, as well as improves postoperative limb alignment in the coronal and sagittal planes.

Keywords: 3D-CT; Femoral component; Robotic assisted total knee arthroplasty; Tibial component.