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Robotic use improves post-resection bone cuts during total knee arthroplasty

3 pagesPublished: October 27, 2019

Abstract

The purposes of this study were to assess 1) number of bone recuts with manual TKA (MTKA) vs RATKA and 2) influence of robotics on surgeon’s posture and workload during recutting.
Two surgeons each performed three MTKAs and three RATKAs. Occurrence, time and type of post-resection recuts were recorded. Movement sensors were placed on surgeons to measure lower back, shoulder, and cervical movements. Data was analyzed for average angle, percent of time in high-risk range of motion (ROM), number of times in high-risk sustained positions, and repetitions per minute. Surgeons were surveyed to assess physical and mental effort on a 1-10 scale (1 as lowest effort).
Six TKAs required recuts, five MTKA and one RATKA. 5 were on tibia and 1 (MTKA) was on femur. Compared to RATKA, MTKA had: increased time to perform recut (4.8-minutes vs. 3.7-minutes), increased occiput and T3 (38.9 vs 17.0° and 16.0 vs 3.0°) average angles, increased lower back ROM, sustained positions, and repetitions (14 vs 0%, 1 vs 0, and 1.9 vs 0), increased non-dominant shoulder ROM and repetitions (22 vs 0% and 2 vs 1), reduced dominant shoulder ROM (56 vs 19%), increased mental (4.2 vs 2.8) efforts and increased physical (3.3 vs 1.7) efforts.
Results indicate RATKA may reduce incidence of post-resection bone recuts. Increased time and required efforts for MTKA may be due to setting up surgical cutting instruments. Whereas, for RATKA, recut changes are made on the robotic surgical screen and the robotic-arm is used to help perform the recut.

Keyphrases: Bone recuts, Robotic assisted TKA, Surgeon ergonomics, Total knee arthroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 325--327

Links:
BibTeX entry
@inproceedings{CAOS2019:Robotic_use_improves_post_resection,
  author    = {Laura Scholl and Emily Hampp and Vincent Alipit and Michael Mont and Anil Bhave and Antonia Chen},
  title     = {Robotic use improves post-resection bone cuts during total knee arthroplasty},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  pages     = {325--327},
  year      = {2019},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/nZbD},
  doi       = {10.29007/r1m3}}
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