A cadaveric experimental study on domestic robot-assisted total knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHAI Wei ¹ , XIE Jie ² , ZHANG Xiaogang ³ , HE Chuan ⁴ , YAN Tingfang ⁵ , LIU Li ⁵ , ZHANG Yuan ⁶ , ZHOU Zongke ⁷ , HU Yihe ² , CAO Li ³ , CHEN Jiying ¹ ,  TANG Peifu ¹

1. Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing, 100853, P.R.China;
2. Department of Orthopedics, Xiangya Hospital Central South University, Changsha Hunan, 410008, P.R.China;
3. Department of Orthopedics, First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang, 830011, P.R.China;
4. Department of Orthopedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P.R.China;
5. Yuanhua Technology Limited, Shenzhen Guangdong, 518000, P.R.China;
6. Department of Orthopedics, Xinqiao Hospital, Affiliated Hospital of Army Medical University, Chongqing, 400037, P.R.China;
7. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding?author：

TANG Peifu, Email: pftang301@126.com

Keywords：

Total knee arthroplasty; surgical robot; cadaveric experiment

DOI：

10.7507/1002-1892.202010021

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To simulate and validate the performance, accuracy, and safety of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through cadaver-based experiment, thus optimizing the robotic system for the future human clinical application.Methods Six unilateral adult cadaver specimens of the lower limbs were scanned by three-dimensional CT before the experiment, and then the three-dimensional models of femur and tibia were obtained by using the preoperative software of YUANHUA-TKA system, so as to plan the type of prosthesis implant, the osteotomy volume and osteotomy angles [hip-knee-ankle angle (HKA), coronal frontal femoral component (FFC) and frontal tibial component (FTC)], the ideal value of HKA was set to 180°, and of FFC and FTC were set to 90°, respectively. The operator could further confirm the osteotomy plan according to the intraoperative situation before osteotomy, and then install the prosthesis after completing the osteotomy in each plane with the assistance of YUANHUA-TKA system. At last, the X-ray films of hip joint, knee joint, and ankle joint were taken and stitched into the full length X-ray film of the lower limb, and HKA, coronal FFC and FTC were measured.Results During the experiment, YUANHUA-TKA system ran stably. All sections of femur and tibia were smooth and no ligament injury was found. After operation, the HKA was 177.1°-179.7°, FFC was 87.9°-91.4°, and FTC was 87.3°-91.4°, which were within ±3° from the ideal values of preoperative planning.Conclusion The YUANHUA-TKA system can assist the surgeon to carry out precise osteotomy according to the preoperative planned value, which has a good auxiliary effect for total knee arthroplasty. It is expected to assist joint surgeons to improve the surgical accuracy in clinical application.

Citation： CHAI Wei, XIE Jie, ZHANG Xiaogang, HE Chuan, YAN Tingfang, LIU Li, ZHANG Yuan, ZHOU Zongke, HU Yihe, CAO Li, CHEN Jiying, TANG Peifu. A cadaveric experimental study on domestic robot-assisted total knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(4): 409-413. doi: 10.7507/1002-1892.202010021 Copy

1.	Panjwani TR, Mullaji A, Doshi K, et al. Comparison of functional outcomes of computer-assisted vs conventional total knee arthroplasty: A systematic review and meta-analysis of high-quality, prospective studies. J Arthroplasty, 2019, 34(3): 586-593.
2.	Wu ZX, Sang HX, Zhou Y, et al. Robot-assisted orthopedic surgery//Pei G. Digital Orthopedics. Berlin: Springer, 2018: 425-447.
3.	Mahdi AS, Svantesson M, Wretenberg P, et al. Patients’ experiences of discontentment one year after total knee arthroplasty-a qualitative study. BMC Musculoskeletal Disorders, 2020, 21(1): 1.
4.	Goh SH, Ming HLL, Razak HRBA, et al. Patient-reported outcomes, quality of life, and satisfaction rates in young patients aged 50 years or younger after total knee arthroplasty. J Arthroplasty, 2017, 32(2): 419-425.
5.	Van Onsem S, Catherine VDS, Arnout N, et al. A new prediction model for patient satisfaction after total knee arthroplasty. J Arthroplasty, 2016, 31(12): 2660-2667.
6.	Liow MHL, Xia Z, Wong MK, et al. Robot-assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study. J Arthroplasty, 2014, 29(12): 2373-2377.
7.	Paul HA, Bargar WL, Mittlestadt B, et al. Development of a surgical robot for cementless total hip arthroplasty. Clin Orthop Relat Res, 1992, 285: 57-66.
8.	Karthik K, Colegate-Stone T, Dasgupta P, et al. Robotic surgery in trauma and orthopaedics: a systematic review. Bone Joint J, 2015, 97(3): 292-299.
9.	Ren Y, Cao S, Wu J, et al. Efficacy and reliability of active robotic-assisted total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J, 2019, 95(1121): 125-133.
10.	李艾俐, 周越, 延廷芳, 等. 手術導航儀: 中國, ZL 201930068351.X. 2019-11-01.
11.	李艾俐, 周越, 延廷芳, 等. 手術機械臂: 中國, ZL 201930067140.4. 2019-09-27.
12.	李艾俐, 周越, 延廷芳, 等. 主控端臺車: 中國, ZL 201930067138.7. 2019-08-06.
13.	柴偉, 謝杰, 張曉崗, 等. 國產全膝關節置換術輔助機器人系統動物實驗研究. 中國修復重建外科雜志, 2020, 34(11): 1376-1381.
14.	魏輝, 楊述華, 劉先哲. 便攜式計算機導航 iASSIST 技術在全膝關節置換術中的應用. 中國骨與關節雜志, 2018, 7(4): 245-250.
15.	Gustke K. Total Knee Arthroplasty Technique: MAKO//Lonner J. Robotics in Knee and Hip Arthroplasty. Berlin: Springer, 2019: 157-166.
16.	趙輝, 趙子健, 劉允才, 等. 一種新型計算機輔助全膝關節置換手術系統: 華佗 (WATO). 中國骨與關節外科, 2009, 2(4): 279-283.

1. Panjwani TR, Mullaji A, Doshi K, et al. Comparison of functional outcomes of computer-assisted vs conventional total knee arthroplasty: A systematic review and meta-analysis of high-quality, prospective studies. J Arthroplasty, 2019, 34(3): 586-593.
2. Wu ZX, Sang HX, Zhou Y, et al. Robot-assisted orthopedic surgery//Pei G. Digital Orthopedics. Berlin: Springer, 2018: 425-447.
3. Mahdi AS, Svantesson M, Wretenberg P, et al. Patients’ experiences of discontentment one year after total knee arthroplasty-a qualitative study. BMC Musculoskeletal Disorders, 2020, 21(1): 1.
4. Goh SH, Ming HLL, Razak HRBA, et al. Patient-reported outcomes, quality of life, and satisfaction rates in young patients aged 50 years or younger after total knee arthroplasty. J Arthroplasty, 2017, 32(2): 419-425.
5. Van Onsem S, Catherine VDS, Arnout N, et al. A new prediction model for patient satisfaction after total knee arthroplasty. J Arthroplasty, 2016, 31(12): 2660-2667.
6. Liow MHL, Xia Z, Wong MK, et al. Robot-assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study. J Arthroplasty, 2014, 29(12): 2373-2377.
7. Paul HA, Bargar WL, Mittlestadt B, et al. Development of a surgical robot for cementless total hip arthroplasty. Clin Orthop Relat Res, 1992, 285: 57-66.
8. Karthik K, Colegate-Stone T, Dasgupta P, et al. Robotic surgery in trauma and orthopaedics: a systematic review. Bone Joint J, 2015, 97(3): 292-299.
9. Ren Y, Cao S, Wu J, et al. Efficacy and reliability of active robotic-assisted total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J, 2019, 95(1121): 125-133.
10. 李艾俐, 周越, 延廷芳, 等. 手術導航儀: 中國, ZL 201930068351.X. 2019-11-01.
11. 李艾俐, 周越, 延廷芳, 等. 手術機械臂: 中國, ZL 201930067140.4. 2019-09-27.
12. 李艾俐, 周越, 延廷芳, 等. 主控端臺車: 中國, ZL 201930067138.7. 2019-08-06.
13. 柴偉, 謝杰, 張曉崗, 等. 國產全膝關節置換術輔助機器人系統動物實驗研究. 中國修復重建外科雜志, 2020, 34(11): 1376-1381.
14. 魏輝, 楊述華, 劉先哲. 便攜式計算機導航 iASSIST 技術在全膝關節置換術中的應用. 中國骨與關節雜志, 2018, 7(4): 245-250.
15. Gustke K. Total Knee Arthroplasty Technique: MAKO//Lonner J. Robotics in Knee and Hip Arthroplasty. Berlin: Springer, 2019: 157-166.
16. 趙輝, 趙子健, 劉允才, 等. 一種新型計算機輔助全膝關節置換手術系統: 華佗 (WATO). 中國骨與關節外科, 2009, 2(4): 279-283.

Chinese Journal of Reparative and Reconstructive Surgery

A cadaveric experimental study on domestic robot-assisted total knee arthroplasty

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content