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Robotic Partial Knee Resurfacing

Robotic partial knee resurfacing allows orthopedic surgeons to plan and perform the procedure with consistently reproducible precision.

When your patients with osteoarthritis (OA) no longer respond to non-surgical treatments or medications, they may be candidates for robotic partial knee resurfacing.

Robotic partial knee resurfacing is an advanced treatment option for adults who have osteoarthritis that has not yet progressed to all three compartments of the knee. Robotic surgery at Baylor Scott & White Health offers a comprehensive range of solutions including: medial, patellofemoral, lateral, and bicompartmental.

Benefits

While total knee arthroplasty (TKA) is a safe and effective treatment option for people with osteoarthritis in their entire knee, it is not always the optimal solution for those with osteoarthritis isolated to only one or two compartments. Partial knee resurfacing spares the ACL and PCL ligaments, as well as healthy bone and tissue.

Robotic partial knee resurfacing offers many benefits over total knee arthroplasty, including:

  • Smaller incision and less scarring
  • Bone sparing and soft-tissue preserving
  • Shorter hospitalization
  • Greater range of motion1
  • A more natural feeling knee2

Robotic Surgery Overcomes the Challenges of Manual Partial Knee Arthroplasty

Manual partial knee procedures are technically challenging and difficult to perform with accuracy. Some of the limitations with manual procedures include:

  • Restricted visual field
  • Substantial complication rates that persist throughout the learning curve3
  • High failure rates associated with inaccurate placement4

The Advantages of Robotic Partial Knee Resurfacing

Surgeons on the medical staff are enabled to plan and perform the procedure with consistently reproducible precision.

  • Patient-specific pre-operative planning –Using the patient’s CT scan, a 3-D model is created to plan implant size, placement and alignment specific to each patient’s unique anatomy.
  • Intra-operative soft-tissue balancing –Robotic surgery provides surgeons on the medical staff with real-time data, enabling assessment of ligament tension throughout range of motion and implant articulation. This enables surgeons to fine tune the plan intra-operatively, if needed, for more accurate soft-tissue balance.
  • Robotic arm assisted resection –The robotic arm provides visual, auditory and tactile feedback during bone resurfacing to help ensure accurate implant fit while conserving bone.

Clinical Effectiveness

Following are results of several studies demonstrating the clinical benefits of robotic arm assisted arthroplasty partial knee resurfacing.

  • Low Two-Year Revision Rates –Robotic PKR demonstrated a low revision rate of 1.1% at two years in a study of 752 patients (854 knees). National Joint Registries cite average revision rates of 4.5% to 4.8% for manual PKR.5
  • Robotic Unicompartmental (UKA) vs. Manual Oxford®– Early results of an ongoing randomized controlled trial (RCT) show more accurate implant placement with medial UKA robotic procedures using RESTORIS® MCK implants, than with manual UKA procedures using Oxford® The study also found patients who had robotic UKA experienced less pain for the first eight weeks after surgery. Comparing American Knee Society Scores, robotic patients also had increased post-operative functionality at three months post-surgery.6
  • Bicompartmental vs. Total Knee Arthroplasty –A study comparing bicompartmental robotic procedures with total knee arthroplasty found that patients who had partial knee resurfacing demonstrated improved function, better post-operative range of motion, and better quadriceps strength.7

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Orthopedics at Baylor Scott & White Health

At Baylor Scott & White Health, we offer expert subspecialty orthopedic care through the use of innovative therapies, minimally invasive surgeries, joint replacement, physical therapy and rehabilitation.

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References

  1. Sinha RK. Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. Am J Orthop. 2009:38(2 suppl):20-22.
  2. McCallister MD. The role of unicompartmental knee arthroplasty versus total knee arthroplasty in providing maximal performance and satisfaction. Jrl of Knee Soc. October 2008;286-292.
  3. Hamilton WG, Ammeen D, Engh CA Jr, Engh GA. Learning curve with minimally invasive unicompartmental knee arthroplasty. J Arthroplasty. August 2010:25(5):735-40.
  4. Epinette JA, Brunschweller B, Mertl P, Mole D, Cazenave A. Unicompartmental knee arthroplasty modes of failure: Wear is not the main reason for failure: A multicenter study of 418 failed knees. Orthop Traumatol Surg Res. October 2012;98(6 suppl):S124-30.
  5. Roche MW, Coon T, Pearle AD, Dounchis J. Two year survivorship of robotically guided medical MCK onlay. 25th Annual Congress of ISTA, October 3-6, 2012, Sydney, Australia.
  6. Jones B, Blyth M, MacLean A, Anthony I, Rowe P. Accuracy of UKA implant positioning and early clinical outcomes in a RCT comparing robotic assisted and manual surgery. CAOS International Conference, June 13-15, 2013, Orlando, Florida.
  7. Kreuzer S, Conditt M, Jones J, Dalal S, Pourmoghaddam A. Functional recovery after bicompartmental arthroplasty, navigated TKA, and traditional TKA. 25th Annual Congress of ISTA, October 3-6, 2012, Sydney, Australia.