Cargando…

Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement

The accurate positioning of the prosthetic components is essential for achieving successful results in medial unicompartmental knee arthroplasty (mUKA). The tibial component rotation in image-based robotic-assisted UKA is usually based on tibial bony landmarks matched to the pre-operative CT model....

Descripción completa

Detalles Bibliográficos
Autores principales: Innocenti, Matteo, Zanna, Luigi, Akkaya, Mustafa, Huber, Kim, Christen, Bernhard, Calliess, Tilman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141020/
https://www.ncbi.nlm.nih.gov/pubmed/37109018
http://dx.doi.org/10.3390/jpm13040632
_version_ 1785033292400033792
author Innocenti, Matteo
Zanna, Luigi
Akkaya, Mustafa
Huber, Kim
Christen, Bernhard
Calliess, Tilman
author_facet Innocenti, Matteo
Zanna, Luigi
Akkaya, Mustafa
Huber, Kim
Christen, Bernhard
Calliess, Tilman
author_sort Innocenti, Matteo
collection PubMed
description The accurate positioning of the prosthetic components is essential for achieving successful results in medial unicompartmental knee arthroplasty (mUKA). The tibial component rotation in image-based robotic-assisted UKA is usually based on tibial bony landmarks matched to the pre-operative CT model. The study aimed to evaluate whether setting the tibial rotation on femoral CT-based landmarks allows congruent knee kinematics. We retrospectively analyzed data from 210 consecutive image-based robotic-assisted mUKA cases. In every case, we set the tibia rotation landmark parallel to the posterior condylar axis and centered it on the trochlea groove defined on the preoperative CT scan. The implant positioning was primarily set parallel to this rotation landmark and then adjusted based on tibial sizes avoiding component over- or under-hang. During surgery, we recorded the knee kinematics under valgus stress to reduce the arthritic deformity. A femoral-tibial contact point was recorded over the entire range of motion and displayed as a tracking profile on the tibia implant. The femoro-tibial tracking angle (FTTA) was then calculated based on a tangent line to the femoro-tibial tracking-points and the difference to the femur-based rotation landmark. In 48% of the cases, we could position the tibia component exactly to the femoral rotation landmark, whereas in 52% of cases, minimal adjustments were made to avoid component’s under- or over-hang. The mean tibia component rotation (TRA) with reference to our femur-based landmark was +0.24° (SD ± 2.9°). The femur-based tibia rotation landmark showed a high correspondence to the FTTA with 60% of the cases having less than 1° of deviation. Mean FTTA was +0.7° (SD ± 2.2°). The mean difference between the absolute value of the TRA and the FTTA (|TRA| − |FTTA|) was −0.18° (SD ± 2°). Setting the tibial component rotation based on CT scan femoral landmarks and not on tibial anatomical landmarks is a reliable method to obtain congruent knee kinematics during image-based robotic-assisted medial UKA with less the 2° deviations on average.
format Online
Article
Text
id pubmed-10141020
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101410202023-04-29 Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement Innocenti, Matteo Zanna, Luigi Akkaya, Mustafa Huber, Kim Christen, Bernhard Calliess, Tilman J Pers Med Article The accurate positioning of the prosthetic components is essential for achieving successful results in medial unicompartmental knee arthroplasty (mUKA). The tibial component rotation in image-based robotic-assisted UKA is usually based on tibial bony landmarks matched to the pre-operative CT model. The study aimed to evaluate whether setting the tibial rotation on femoral CT-based landmarks allows congruent knee kinematics. We retrospectively analyzed data from 210 consecutive image-based robotic-assisted mUKA cases. In every case, we set the tibia rotation landmark parallel to the posterior condylar axis and centered it on the trochlea groove defined on the preoperative CT scan. The implant positioning was primarily set parallel to this rotation landmark and then adjusted based on tibial sizes avoiding component over- or under-hang. During surgery, we recorded the knee kinematics under valgus stress to reduce the arthritic deformity. A femoral-tibial contact point was recorded over the entire range of motion and displayed as a tracking profile on the tibia implant. The femoro-tibial tracking angle (FTTA) was then calculated based on a tangent line to the femoro-tibial tracking-points and the difference to the femur-based rotation landmark. In 48% of the cases, we could position the tibia component exactly to the femoral rotation landmark, whereas in 52% of cases, minimal adjustments were made to avoid component’s under- or over-hang. The mean tibia component rotation (TRA) with reference to our femur-based landmark was +0.24° (SD ± 2.9°). The femur-based tibia rotation landmark showed a high correspondence to the FTTA with 60% of the cases having less than 1° of deviation. Mean FTTA was +0.7° (SD ± 2.2°). The mean difference between the absolute value of the TRA and the FTTA (|TRA| − |FTTA|) was −0.18° (SD ± 2°). Setting the tibial component rotation based on CT scan femoral landmarks and not on tibial anatomical landmarks is a reliable method to obtain congruent knee kinematics during image-based robotic-assisted medial UKA with less the 2° deviations on average. MDPI 2023-04-04 /pmc/articles/PMC10141020/ /pubmed/37109018 http://dx.doi.org/10.3390/jpm13040632 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Innocenti, Matteo
Zanna, Luigi
Akkaya, Mustafa
Huber, Kim
Christen, Bernhard
Calliess, Tilman
Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title_full Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title_fullStr Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title_full_unstemmed Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title_short Setting the Tibial Component Rotation Based on Femoral Landmarks Allows Congruent Knee Kinematics in Robotic-Assisted Medial Unicompartmental Knee Replacement
title_sort setting the tibial component rotation based on femoral landmarks allows congruent knee kinematics in robotic-assisted medial unicompartmental knee replacement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141020/
https://www.ncbi.nlm.nih.gov/pubmed/37109018
http://dx.doi.org/10.3390/jpm13040632
work_keys_str_mv AT innocentimatteo settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement
AT zannaluigi settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement
AT akkayamustafa settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement
AT huberkim settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement
AT christenbernhard settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement
AT calliesstilman settingthetibialcomponentrotationbasedonfemorallandmarksallowscongruentkneekinematicsinroboticassistedmedialunicompartmentalkneereplacement