Abstract
Barriers to the adoption of unicompartmental knee arthroplasty (UKA) by new consultants could be explained by its higher revision rate, to which mal-positioned components contribute. The aim of this study was to determine whether robotic technology enables inexperienced surgeons to perform accurate UKAs when compared to current conventional methods
After randomisation, sixteen trainees who had never performed UKAs performed three medial UKAs (Corin Uniglide), one per week, on dry-bone simulators by either robotic (Sculptor RGA) or conventional methods. They were instructed to match a universal 3D-CT based pre-operative plan that would result from a UKA based on the conventional jigs and operating guide. The knees were laser scanned and software used to compare the planned and actual implant positions. Feedback was given to trainees between attempts. Translational and rotational positioning errors were measured in all six degrees of freedom for both components
At all attempts robotic medial UKAs were more accurate in both translational and rotational alignments for both components reaching statistical significance (p<0.005) at all attempts for rotational errors. Considering outliers, the maximum rotational errors of the robot group was 9° and 7° for the tibial and femoral components respectively. For the conventional group this reached 18° and 16° for the tibial and femoral components respectively
Robotic technology allows inexperienced surgeons to perform medial UKAs on dry bone models with acceptable accuracy and precision on their first attempt. Conventional jigs do not. The adoption of robotic technology might provide new consultants with the confidence to offer UKAs to their patients by limiting the inaccuracies inherent in conventional equipment.
