A literature review of robotic systems showed that these systems can , similarly to computer navigation , reliably improve lower leg alignment , component positioning and soft tissues balancing .
Findings in this study suggest that computer navigation or robotic assistance may help managing these multiple variables and could improve outcomes .
Recently , there is a growing interest in surgical variables that are intraoperatively controlled by orthopaedic surgeons , including lower leg alignment , component positioning and soft tissues balancing .
Since more tight control over these factors is associated with improved outcomes of unicompartmental knee arthroplasty and total knee arthroplasty ( TKA ) , several computer navigation and robotic-assisted systems have been developed .
Although mechanical axis accuracy and component positioning have been shown to improve with computer navigation , no superiority in functional outcomes has yet been shown .
This could be explained by the fact that many differences exist between the number and type of surgical variables these systems control .
Most systems control lower leg alignment and component positioning , while some in addition control soft tissue balancing .
Finally , robotic-assisted systems have the additional advantage of improving surgical precision .
Manually controlling all these surgical variables can be difficult for the orthopaedic surgeon .
Computer-assisted gap balancing technique improves outcome in total knee arthroplasty, compared with conventional measured resection technique
Purpose The objective of this prospect i ve study was to compare the functional outcome of conventional measured resection technique and computer-assisted gap balancing technique in TKA . Methods 140 patients were r and omized into two groups . The conventional measured resection technique without computer navigation was performed in Group 1 and the computer-assisted gap balancing technique in Group 2 . Range of motion , clinical laxity assessment with KT-1000 arthrometer , postoperative radiological films and various functional knee scores were documented at 6 months and 2 years . Results At 2 years , there were significantly more patients ( five patients , 7 % ) in the Group 1 with flexion contractures of more than 5 ° ( P = 0.05 ) . There were significantly more outliers in the Group 1 ( eight patients , 11 % ) , who demonstrated anterior tibial translation > 5 mm , than Group 2 ( two patients , 3 % ) ( P = 0.041 ) . The total excursion at 20 ° was significantly higher in Group 1 at 6 months ( P = 0.012 ) and after 2 years ( P = 0.031 ) . Group 2 was able to demonstrate significantly better limb alignment with fewer outliers ( more than 3 ° varus/valgus ) than Group 1 . At 6-month follow-up , Group 2 demonstrated better outcomes in Function Score ( P = 0.040 ) and Total Oxford Score ( P = 0.031 ) . At 2-year review , Group 2 had better outcome in the Total Oxford Score ( 0.030 ) . Conclusion Computer-assisted gap balancing technique was able to achieve more precise soft tissue balance and restoration of limb alignment with better knee scores as compared to the conventional measured resection technique in total knee arthroplasty . Level of evidence
A literature review of robotic systems showed that these systems can , similarly to computer navigation , reliably improve lower leg alignment , component positioning and soft tissues balancing .
Findings in this study suggest that computer navigation or robotic assistance may help managing these multiple variables and could improve outcomes .
Recently , there is a growing interest in surgical variables that are intraoperatively controlled by orthopaedic surgeons , including lower leg alignment , component positioning and soft tissues balancing .
Since more tight control over these factors is associated with improved outcomes of unicompartmental knee arthroplasty and total knee arthroplasty ( TKA ) , several computer navigation and robotic-assisted systems have been developed .
Although mechanical axis accuracy and component positioning have been shown to improve with computer navigation , no superiority in functional outcomes has yet been shown .
This could be explained by the fact that many differences exist between the number and type of surgical variables these systems control .
Most systems control lower leg alignment and component positioning , while some in addition control soft tissue balancing .
Finally , robotic-assisted systems have the additional advantage of improving surgical precision .
Manually controlling all these surgical variables can be difficult for the orthopaedic surgeon .