How reproducible are clinical measurements in robotic knee surgery?

Abstract

Abstract Purpose Robotic‐assisted surgery has been recently introduced to improve biomechanical restoration, and thus better clinical and functional outcomes, after knee joint arthroplasty operations. Robotic‐assisted uni‐compartmental knee arthroplasty (UKA) aims indeed to improve surgical bone resection and alignment accuracy, optimized component positioning and knee balancing, relying on a series of calibration measurements performed during the surgery. These advantages focus therefore on improving the reproducibility of UKA surgeries, reducing (if not eliminating) eventual differences among high‐ and low‐volume surgeons. The purpose of this study is to investigate and quantify the reproducibility of in‐vivo measurements performed with a robotic system: the intra‐ and inter‐observer variability of a series of measurements was therefore analyzed and compared among differently experienced operators. Methods Five patients were analyzed and underwent robotic‐assisted UKA using a semi‐active robotic system. Three different observers with different experience levels were involved to independently perform the measurements of two parameters of the preoperative knee (Hip‐Knee‐Ankle angle [HKAa], Internal‐External Rotation) at different degrees of knee flexion. Inter‐observer and intra‐observer comparisons were performed. Results The average variability in the measurements obtained from the intra‐observer and inter‐observer comparisons were always 0.75) for most cases and good agreement (> 0.60) in the remaining ones. Conclusion This study demonstrated high reproducibility of the measurements obtainable in clinical environment with the robotic system. The inter‐observer results furthermore showed that the level of confidence with the robotic system is not significantly influencing the measurement.

Keywords

• Robotic surgery
• Knee surgery
• Reproducibility
• Variability
• In vivo measurements