Abstract
Introduction
Recently robotic-assisted total knee replacement has become a new emerging method of artificial joint implantation, especially in Europe and Asia. We have belived that robotic cutting would result in an improved clinical outcome due to the better fit and alignment of the prosthesis but that has never been proven to our knowledge. The purpose of this study was to compare robotic-assisted implantation of a total knee replacement with conventional manual implantation.
Methods
We reviewed 72 patients who were scheduled for total knee arthroplasty, divided to have either conventional manual implantation of a Zimmer LPS prosthesis (30 patients: Group I) or robotic-assisted implantation of such a prosthesis (32 patients: Group II). The five-axis ROBODOC was used for the robotic-assisted procedures. Radiographs were made at this interval and analyzed for evidence of loosening, prosthetic alignment, and other complications. Independent T-test or Mann-Whitney test was used for statistical analysis at probability level of 95%. SPSS for Windows was used.
Results
The age of group I was 67.8±6.44 years and that of group II was 62.7±6.51 years. The follow up period of group I was 31.3±3.47 months and that of group II was 27.0±0.69 years. In clinical assessment, there was no difference statistically. In radiological assessment, the postoperative tibiofemoral angles of group I was 5.3±2.6 degrees and that of group II was 6.0±1.8 degrees. There was no difference statistically. The α and β angle of group I was 95.6±2.65, 88.6±2.58 degrees and that of group II was 97.7±0.97, 88.8±1.59 degrees. There was no difference statistically. The γ and δ angle of group I was 4.19±3.28, 85.5±0.92 degrees and that of group II was 0.17±0.65, 89.7±1.7 degrees. There was a significant statistical difference(P<0.05). The complications were observed in Group II: 1 superficial infection, 1 patellar tendon rupture, 1 postoperative supracondylar fracture and 1 peroneal nerve palsy.
Discussion
The robotic-assisted technology had definite advantages in terms of preoperative planning, the accuracy of the intraoperative procedure and postoperative follow up in lateral knee radiograph, especially in γ and δ angle. But disadvantages were the high complication rate, which we believe was required for the more careful and experienced operative technique. We need further kinematical study about the clinical importance of γ and δ angle in TKA patients, especially wear pattern etc before robotic popular usage in USA.
