Variability in Alignment and Bone Resections in Robotically Balanced Total Knee Arthroplasties
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Data Collection
2.3. Data Analyses
2.4. Patient Characteristics
3. Results
3.1. Target Alignments and Resection Magnitudes by Demographics
3.2. Target Alignments Compared by Preoperative Alignment Category
3.3. Target Resection Magnitudes Compared by Preoperative Alignment Category
3.4. Metric Variability
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Varus (n = 191) | Neutral (n = 189) | Valgus (n = 104) | |||||
---|---|---|---|---|---|---|---|
M ± SD | Range | M ± SD | Range | M ± SD | Range | p-Value | |
Age (years) | 67.9 ± 8.9 | 45–94 | 67.7 ± 8.9 | 42–88 | 67 ± 8.6 | 45–85 | 0.716 |
Male—no. (%) | 71 (37.2) | - | 52 (27.5) | - | 17 (16.3) | - | <0.001 |
BMI (kg/m2) | 31.4 ± 5.5 | 18.2–46.2 | 32.7 ± 5.3 | 20.8–46.1 | 31.7 ± 5.8 | 20.5–47.5 | 0.064 |
Preop Dx | 0.585 | ||||||
OA | 189 (99.0) | - | 187 (98.9) | - | 103 (99.0) | - | |
Trauma | 2 (1.0) | - | 1 (0.5) | - | - | - | |
RA | - | - | 1 (0.5) | - | 1 (1.0) | - | |
Race—no. (%) | 0.031 | ||||||
White | 96 (50.3) | - | 99 (52.4) | - | 52 (50.0) | - | |
Black | 29 (15.2) | - | 35 (18.5) | - | 18 (17.3) | - | |
Asian | 20 (10.5) | - | 19 (10.1) | - | 1 (1.0) | - | |
Other | 46 (24.1) | - | 36 (19.0) | - | 33 (31.7) | - | |
Smoking—no. (%) | 0.069 | ||||||
Current | 6 (3.1) | - | 8 (4.2) | - | 2 (1.9) | - | |
Former | 38 (19.9) | - | 58 (30.7) | - | 34 (32.7) | - | |
Never | 144 (75.4) | - | 120 (63.5) | - | 64 (61.5) | - | |
N/A | 3 (1.6) | - | 3 (1.6) | - | 4 (3.8) | - | |
ASA Class—no. (%) | 0.751 | ||||||
1 | 6 (3.1) | - | 5 (2.6) | - | 3 (2.9) | - | |
2 | 109 (57.1) | - | 107 (56.6) | - | 67 (64.4) | - | |
3 | 75 (39.3) | - | 76 (40.2) | - | 34 (32.7) | - | |
4 | 1 (0.5) | - | - | - | - | - | |
N/A | - | - | 1 (0.5) | - | - | - |
Varus (n = 191) | Neutral (n = 189) | Valgus (n = 104) | |||||
---|---|---|---|---|---|---|---|
M ± SD | Range | M ± SD | Range | M ± SD | Range | p-Value | |
Preoperative aHKA (degrees) 1 | * 4.9 ± 2.2 | 2.1–12.8 | 0.2 ± 1.1 | −2.0–2.0 | * −4.7 ± 2.1 | −12.5–−2.1 | <0.001 |
Planned coronal alignment (degrees) 1 | |||||||
Limb | * 3.0 ± 1.7 | −2.0–6.2 | 0.9 ± 1.4 | −4.0–4.4 | −1.3 ± 1.4 | −4.5–2.2 | <0.001 |
Distal femur | 0.8 ± 1.2 | −3.5–4 | −0.3 ± 1.2 | −4.5–2.5 | −1.4 ± 1.2 | −4.5–2.0 | <0.001 |
Proximal tibia | 2.2 ± 1.1 | −1.0–5.1 | 1.2 ± 1.2 | −1.0–4.0 | 0.1 ± 1.0 | −2.0–3.5 | <0.001 |
Planned transverse rotation (degrees) 2 | |||||||
Femoral TEA | * 2.4 ± 1.8 | −3.0–6.0 | * 2.1 ± 1.8 | −3.9–6.5 | * 0.5 ± 2.0 | −5.2–5.0 | <0.001 |
Femoral PCA | * 5.0 ± 2.0 | −0.8–9.5 | * 4.8 ± 2.1 | −0.6–9.9 | * 3.7 ± 2.0 | −0.3–10.0 | <0.001 |
Planned sagittal alignment (degrees) | |||||||
Femoral flexion 3 | 3.9 ± 1.4 | 0.0–7.5 | 4 ± 1.5 | 0.5–8.0 | 4.1 ± 1.5 | 0.0–8.0 | 0.614 |
Tibial slope 4 | 3.3 ± 0.6 | 2.0–5.5 | 3.2 ± 0.6 | 2.0–5.8 | 3.3 ± 0.6 | 2.0–5.5 | 0.357 |
Distal femur resection (mm) | |||||||
Lateral | 5.5 ± 1.5 | 0.5–9.5 | 4.6 ± 1.5 | 1.0–8.5 | 3.4 ± 1.4 | 0.5–7.0 | <0.001 |
Medial | * 7.1 ± 1.7 | 1.5–11.0 | 7.3 ± 1.2 | 4.0–10.0 | 7.3 ± 1.2 | 4.5–11.0 | 0.431 |
Posterior femur resection (mm) | |||||||
Lateral | * 5.8 ± 1.7 | 0.5–10.0 | * 5.6 ± 1.8 | 1.5–11.5 | * 5.7 ± 1.7 | 1.5–9.5 | 0.429 |
Medial | 10.0 ± 1.5 | 6.0–13.5 | 9.5 ± 1.5 | 4.0–14.5 | 8.6 ± 1.4 | 5.5–12.5 | <0.001 |
Tibia resection (mm) | |||||||
Lateral | 6.3 ± 1.2 | 2.0–10.0 | 6.3 ± 1.2 | 2.5–10.0 | 5.6 ± 1.5 | 2.0–10.0 | <0.001 |
Medial | 3.8 ± 1.3 | 0.5–8.0 | 4.6 ± 1.3 | 1.0–9.0 | 4.9 ± 1.4 | 1.0–7.5 | <0.001 |
Sum of extension resections (mm) | |||||||
Lateral | * 11.9 ± 1.9 | 6.5–17.5 | * 10.8 ± 1.8 | 6.0–15.5 | * 9.0 ± 1.8 | 4.5–14.0 | <0.001 |
Medial | * 10.9 ± 2.2 | 3.5–17.5 | * 11.9 ± 1.7 | 7.0–16 | 12.2 ± 1.5 | 8.0–16.5 | <0.001 |
Sum of flexion resections (mm) | |||||||
Lateral | * 12.1 ± 1.9 | 5.5–17.5 | * 11.9 ± 1.9 | 6.0–17.0 | * 11.3 ± 1.9 | 6.5–16.0 | 0.001 |
Medial | * 13.8 ± 1.7 | 8.0–17.0 | * 14.0 ± 1.6 | 8.5–19.0 | * 13.5 ± 1.6 | 9.5–18.0 | 0.030 |
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Hepinstall, M.S.; Di Gangi, C.; Oakley, C.; Sybert, M.; Meere, P.A.; Meftah, M. Variability in Alignment and Bone Resections in Robotically Balanced Total Knee Arthroplasties. Bioengineering 2024, 11, 845. https://doi.org/10.3390/bioengineering11080845
Hepinstall MS, Di Gangi C, Oakley C, Sybert M, Meere PA, Meftah M. Variability in Alignment and Bone Resections in Robotically Balanced Total Knee Arthroplasties. Bioengineering. 2024; 11(8):845. https://doi.org/10.3390/bioengineering11080845
Chicago/Turabian StyleHepinstall, Matthew S., Catherine Di Gangi, Christian Oakley, Michael Sybert, Patrick A. Meere, and Morteza Meftah. 2024. "Variability in Alignment and Bone Resections in Robotically Balanced Total Knee Arthroplasties" Bioengineering 11, no. 8: 845. https://doi.org/10.3390/bioengineering11080845