The purpose of this multicentre observational study was to investigate the association between intraoperative component positioning and soft-tissue balancing on short-term clinical outcomes in patients undergoing robotic-arm assisted unicompartmental knee arthroplasty (UKA). Between 2013 and 2016, 363 patients (395 knees) underwent robotic-arm assisted UKAs at two centres. Pre- and postoperatively, patients were administered Knee Injury and Osteoarthritis Score (KOOS) and Forgotten Joint Score-12 (FJS-12). Results were stratified as “good” and “bad” if KOOS/FJS-12 were more than or equal to 80. Intraoperative, post-implantation robotic data relative to CT-based components placement were collected and classified. Postoperative complications were recorded.Aims
Patients and Methods
Robotic technology has been applied to unicompartmental knee arthroplasty (UKA) in order to improve surgical precision in prosthetic component placement, restore knee anatomic surfaces, and provide a more physiologic ligament tensioning throughout the knee range of motion. Recent literature has demonstrated the reliability of robotic assisted UKA over manual UKA in component placement and executing a soft-tissue tensioning plan. The purpose of this multicenter study was to determine the correlation between 3D component positioning and soft-tissue tensioning with short-term clinical results following robotic assisted medial UKA. Between 2013 and 2016, 349 patients (381 knees) underwent robotic assisted fixed bearing metal backed medial UKAs at two centres. Follow-up was performed at 12 months minimum. Pre- and post-operatively, patients were administered Knee Injury and Osteoarthritis Score (KOOS), Forgotten Joint Score 12 (FJS), and Short-Form summary scale (SF-12) surveys. Clinical results for every score were stratified as ‘excellent’, ‘mild’ and ‘insufficient’. Post-operative complications were recorded. Failure mechanisms, reoperations and post-operative knee pain were also assessed. Intra-operative robotic data relative to femoral and tibial component placement in the coronal, sagittal and horizontal plane, as well as femoro-tibial gaps at different knee flexion angles were also collected.Introduction
Methods
Stimulation of bone healing and bone formation through local application of growth factors may improve the clinical outcome in high tibial osteotomy in varus knee. The goal of the present study is to evaluate the effectiveness of autologous growth factors asscociated with or without granular coralline hydroxyapatite used to fill open wedge defects after tibial osteotomy for valgisation in 13 patients with medial femorotibial degeneration. The integration of the coralline hydroxyapatite was complete in every case; we did not encounter any general or local problems, nor were there any intra-operative, peri-operative or post-operative complications. We conclude that local application of autologous growth factors associated with coralline hydroxyapatite is a good solution to stimulate callus formation and ossification in the early phase of bone healing and can substitute bone graft to fill bone defects.
