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

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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.
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14.	魏辉, 杨述华, 刘先哲. 便携式计算机导航 iASSIST 技术在全膝关节置换术中的应用. 中国骨与关节杂志, 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.	赵辉, 赵子健, 刘允才, 等. 一种新型计算机辅助全膝关节置换手术系统: 华佗 (WATO). 中国骨与关节外科, 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. 手术导航仪: 中国, ZL 201930068351.X. 2019-11-01.
11. 李艾俐, 周越, 延廷芳, 等. 手术机械臂: 中国, ZL 201930067140.4. 2019-09-27.
12. 李艾俐, 周越, 延廷芳, 等. 主控端台车: 中国, ZL 201930067138.7. 2019-08-06.
13. 柴伟, 谢杰, 张晓岗, 等. 国产全膝关节置换术辅助机器人系统动物实验研究. 中国修复重建外科杂志, 2020, 34(11): 1376-1381.
14. 魏辉, 杨述华, 刘先哲. 便携式计算机导航 iASSIST 技术在全膝关节置换术中的应用. 中国骨与关节杂志, 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. 赵辉, 赵子健, 刘允才, 等. 一种新型计算机辅助全膝关节置换手术系统: 华佗 (WATO). 中国骨与关节外科, 2009, 2(4): 279-283.

Chinese Journal of Reparative and Reconstructive Surgery

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

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