Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System
Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arth...
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Veröffentlicht in: | The Journal of arthroplasty 2024-08, Vol.39 (8), p.S280-S284 |
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creator | Cochrane, Niall H. Kim, Billy I. Stauffer, Taylor P. Hallows, Rhett K. Urish, Kenneth L. Carvajal Alba, Jaime A. Seyler, Thorsten M. |
description | Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes.
This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at 3 tertiary academic centers. Patient demographics, perioperative surgical data, and 90-day outcomes were collected. Pain and Patient-Reported Outcomes Measurement Information System scores preoperatively and postoperatively were recorded. All-cause reoperations at the final follow-up were detailed. The mean patient age was 65 years (range, 43 to 88), and 58% were women. The mean follow-up time was 13 months (range, 3 to 51).
The most common indications for rTKA were instability (n = 37, 32%) and aseptic loosening (n = 42, 37%). There were 83 rTKAs to a posterior-stabilized liner, 22 to a varus-valgus constrained liner, and 5 to a hinged construct. The median polyethylene size was 11 (interquartile range, 10 to 13), and 93% of patients had their joint line restored within 5 millimeters of the native contralateral knee. Within the 90-day postoperative window, there were 8 emergency department visits and 2 readmissions. At the final follow-up, there were 5 reoperations and 2 manipulations under anesthesia. There were 4 patients who required irrigation and debridement after superficial wound dehiscence, and one had an arthrotomy disruption after a fall.
This review demonstrates favorable intraoperative and 90-day outcomes and suggests that imageless robotic surgery is a promising modality in rTKA. Further studies comparing the longitudinal outcomes after robotic and conventional rTKA are warranted. |
doi_str_mv | 10.1016/j.arth.2024.02.018 |
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This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at 3 tertiary academic centers. Patient demographics, perioperative surgical data, and 90-day outcomes were collected. Pain and Patient-Reported Outcomes Measurement Information System scores preoperatively and postoperatively were recorded. All-cause reoperations at the final follow-up were detailed. The mean patient age was 65 years (range, 43 to 88), and 58% were women. The mean follow-up time was 13 months (range, 3 to 51).
The most common indications for rTKA were instability (n = 37, 32%) and aseptic loosening (n = 42, 37%). There were 83 rTKAs to a posterior-stabilized liner, 22 to a varus-valgus constrained liner, and 5 to a hinged construct. The median polyethylene size was 11 (interquartile range, 10 to 13), and 93% of patients had their joint line restored within 5 millimeters of the native contralateral knee. Within the 90-day postoperative window, there were 8 emergency department visits and 2 readmissions. At the final follow-up, there were 5 reoperations and 2 manipulations under anesthesia. There were 4 patients who required irrigation and debridement after superficial wound dehiscence, and one had an arthrotomy disruption after a fall.
This review demonstrates favorable intraoperative and 90-day outcomes and suggests that imageless robotic surgery is a promising modality in rTKA. Further studies comparing the longitudinal outcomes after robotic and conventional rTKA are warranted.</description><identifier>ISSN: 0883-5403</identifier><identifier>ISSN: 1532-8406</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2024.02.018</identifier><identifier>PMID: 38355066</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>90-day outcomes ; Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee - instrumentation ; Arthroplasty, Replacement, Knee - methods ; Female ; Humans ; imageless ; Knee Joint - surgery ; Knee Prosthesis ; Male ; Middle Aged ; Prosthesis Failure ; Reoperation - statistics & numerical data ; Retrospective Studies ; revision knee arthroplasty ; Robotic Surgical Procedures - methods ; robotics ; second-generation ; Treatment Outcome</subject><ispartof>The Journal of arthroplasty, 2024-08, Vol.39 (8), p.S280-S284</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-e670dce5e2b2666bf9e1841741ef026589314dfafd2960164e5863d82f0c23ca3</cites><orcidid>0000-0002-0767-0811</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2024.02.018$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38355066$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cochrane, Niall H.</creatorcontrib><creatorcontrib>Kim, Billy I.</creatorcontrib><creatorcontrib>Stauffer, Taylor P.</creatorcontrib><creatorcontrib>Hallows, Rhett K.</creatorcontrib><creatorcontrib>Urish, Kenneth L.</creatorcontrib><creatorcontrib>Carvajal Alba, Jaime A.</creatorcontrib><creatorcontrib>Seyler, Thorsten M.</creatorcontrib><title>Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes.
This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at 3 tertiary academic centers. Patient demographics, perioperative surgical data, and 90-day outcomes were collected. Pain and Patient-Reported Outcomes Measurement Information System scores preoperatively and postoperatively were recorded. All-cause reoperations at the final follow-up were detailed. The mean patient age was 65 years (range, 43 to 88), and 58% were women. The mean follow-up time was 13 months (range, 3 to 51).
The most common indications for rTKA were instability (n = 37, 32%) and aseptic loosening (n = 42, 37%). There were 83 rTKAs to a posterior-stabilized liner, 22 to a varus-valgus constrained liner, and 5 to a hinged construct. The median polyethylene size was 11 (interquartile range, 10 to 13), and 93% of patients had their joint line restored within 5 millimeters of the native contralateral knee. Within the 90-day postoperative window, there were 8 emergency department visits and 2 readmissions. At the final follow-up, there were 5 reoperations and 2 manipulations under anesthesia. There were 4 patients who required irrigation and debridement after superficial wound dehiscence, and one had an arthrotomy disruption after a fall.
This review demonstrates favorable intraoperative and 90-day outcomes and suggests that imageless robotic surgery is a promising modality in rTKA. Further studies comparing the longitudinal outcomes after robotic and conventional rTKA are warranted.</description><subject>90-day outcomes</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Knee - instrumentation</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Female</subject><subject>Humans</subject><subject>imageless</subject><subject>Knee Joint - surgery</subject><subject>Knee Prosthesis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prosthesis Failure</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>revision knee arthroplasty</subject><subject>Robotic Surgical Procedures - methods</subject><subject>robotics</subject><subject>second-generation</subject><subject>Treatment Outcome</subject><issn>0883-5403</issn><issn>1532-8406</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLAzEURoMoWh9_wIXM0oUz3jybghsRXygIWnEZ0swdTZmZ1CQV-u-dUnXp6m7Od-AeQo4pVBSoOp9XNuaPigETFbAKqN4iIyo5K7UAtU1GoDUvpQC-R_ZTmgNQKqXYJXtccylBqRGZPuOXTz70xTRk2xYPPWJxOWhjWLQ25VXx5vNHYfvivrPv2GJKZ8ULutDX5S32GG1ej5_DLGTvipdVytgdkp3GtgmPfu4Beb25nl7dlY9Pt_dXl4-l4zDOJaox1A4lshlTSs2aCVIt6FhQbIApqSecirqxTc0manhYoNSK15o14Bh3lh-Q0413EcPnElM2nU8O29b2GJbJsAkbMyqohAFlG9TFkFLExiyi72xcGQpmXdPMzbqmWdc0wMxQcxid_PiXsw7rv8lvvgG42AA4fPnlMZrkPPYOax_RZVMH_5__Gzh0hYA</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Cochrane, Niall H.</creator><creator>Kim, Billy I.</creator><creator>Stauffer, Taylor P.</creator><creator>Hallows, Rhett K.</creator><creator>Urish, Kenneth L.</creator><creator>Carvajal Alba, Jaime A.</creator><creator>Seyler, Thorsten M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0767-0811</orcidid></search><sort><creationdate>20240801</creationdate><title>Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System</title><author>Cochrane, Niall H. ; Kim, Billy I. ; Stauffer, Taylor P. ; Hallows, Rhett K. ; Urish, Kenneth L. ; Carvajal Alba, Jaime A. ; Seyler, Thorsten M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-e670dce5e2b2666bf9e1841741ef026589314dfafd2960164e5863d82f0c23ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>90-day outcomes</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Knee - instrumentation</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Female</topic><topic>Humans</topic><topic>imageless</topic><topic>Knee Joint - surgery</topic><topic>Knee Prosthesis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prosthesis Failure</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>revision knee arthroplasty</topic><topic>Robotic Surgical Procedures - methods</topic><topic>robotics</topic><topic>second-generation</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cochrane, Niall H.</creatorcontrib><creatorcontrib>Kim, Billy I.</creatorcontrib><creatorcontrib>Stauffer, Taylor P.</creatorcontrib><creatorcontrib>Hallows, Rhett K.</creatorcontrib><creatorcontrib>Urish, Kenneth L.</creatorcontrib><creatorcontrib>Carvajal Alba, Jaime A.</creatorcontrib><creatorcontrib>Seyler, Thorsten M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cochrane, Niall H.</au><au>Kim, Billy I.</au><au>Stauffer, Taylor P.</au><au>Hallows, Rhett K.</au><au>Urish, Kenneth L.</au><au>Carvajal Alba, Jaime A.</au><au>Seyler, Thorsten M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>39</volume><issue>8</issue><spage>S280</spage><epage>S284</epage><pages>S280-S284</pages><issn>0883-5403</issn><issn>1532-8406</issn><eissn>1532-8406</eissn><abstract>Robotic-assisted total knee arthroplasty is increasingly used in revision total knee arthroplasty (rTKA), with imageless systems recently receiving Food and Drug Administration (FDA) approval. However, there remains a paucity of literature on the use of robotic assistance in revision total knee arthroplasty (TKA). This paper describes the imageless surgical technique for robotic revision TKA using a second-generation robotic system and details both intraoperative and 90-day outcomes.
This was a retrospective review of 115 robotic revision TKAs from March 2021 to May 2023 at 3 tertiary academic centers. Patient demographics, perioperative surgical data, and 90-day outcomes were collected. Pain and Patient-Reported Outcomes Measurement Information System scores preoperatively and postoperatively were recorded. All-cause reoperations at the final follow-up were detailed. The mean patient age was 65 years (range, 43 to 88), and 58% were women. The mean follow-up time was 13 months (range, 3 to 51).
The most common indications for rTKA were instability (n = 37, 32%) and aseptic loosening (n = 42, 37%). There were 83 rTKAs to a posterior-stabilized liner, 22 to a varus-valgus constrained liner, and 5 to a hinged construct. The median polyethylene size was 11 (interquartile range, 10 to 13), and 93% of patients had their joint line restored within 5 millimeters of the native contralateral knee. Within the 90-day postoperative window, there were 8 emergency department visits and 2 readmissions. At the final follow-up, there were 5 reoperations and 2 manipulations under anesthesia. There were 4 patients who required irrigation and debridement after superficial wound dehiscence, and one had an arthrotomy disruption after a fall.
This review demonstrates favorable intraoperative and 90-day outcomes and suggests that imageless robotic surgery is a promising modality in rTKA. Further studies comparing the longitudinal outcomes after robotic and conventional rTKA are warranted.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38355066</pmid><doi>10.1016/j.arth.2024.02.018</doi><orcidid>https://orcid.org/0000-0002-0767-0811</orcidid></addata></record> |
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subjects | 90-day outcomes Adult Aged Aged, 80 and over Arthroplasty, Replacement, Knee - instrumentation Arthroplasty, Replacement, Knee - methods Female Humans imageless Knee Joint - surgery Knee Prosthesis Male Middle Aged Prosthesis Failure Reoperation - statistics & numerical data Retrospective Studies revision knee arthroplasty Robotic Surgical Procedures - methods robotics second-generation Treatment Outcome |
title | Revision Total Knee Arthroplasty With an Imageless, Second-Generation Robotic System |
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