Efficacy of the Pre-operative Three-Dimensional (3D) CT Scan Templating in Predicting Accurate Implant Size and Alignment in Robot Assisted Total Knee Arthroplasty,Indian Journal of Orthopaedics

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Efficacy of the Pre-operative Three-Dimensional (3D) CT Scan Templating in Predicting Accurate Implant Size and Alignment in Robot Assisted Total Knee Arthroplasty
Indian Journal of Orthopaedics ( IF 1.1 ) Pub Date : 2022-09-17 , DOI: 10.1007/s43465-022-00742-0
Sanjay Bhalchandra Londhe ₁ , Santosh Shetty ₁ , Niraj L Vora ₁ , Ashit Shah ₁ , Rakesh Nair ₁ , Vijay Shetty ₁ , Clevio Desouza ₂ , Farheen Shehzad Khan ₃

Affiliation

Background

Nearly 20% of Total knee Arthroplasty patients remain dissatisfied. This is a major concern in twenty-first century arthroplasty practice. Accurate implant sizing is shown to improve the implant survival, knee balance and patient reported outcome. Aim of the current study is to assess the efficacy of pre-operative three-dimensional (3D) CT scan templating in a robot-assisted TKA in predicting the correct implant sizes and alignment.

Materials and methods

Prospectively collected data in a single center from 30 RA-TKAs was assessed. Inclusion criterion was patients with end stage arthritis (both osteoarthritis and rheumatoid arthritis) undergoing primary TKA. Patients undergoing revision TKA and patients not willing to participate in the study were excluded. Preliminary study of ten patients had indicated almost 100% accuracy in determining the implant size and position. Sample size was estimated to be 28 for 90% reduction in implant size and position error with α error of 0.05 and beta error of 0.20 with power of study being 80. Post-operative radiographs were assessed by an independent observer with respect to implant size and position. The accuracy of femoral and tibial component sizing in the study was compared with the historic control with Chi-squared test. The p value < 0.05 was considered significant.

Results

The pre-operative CT scan 3D templating accuracy was 100% (30 out of 30 knees) for femoral component and 96.67% (29 out of 30 knees) for tibial component. The implant position and limb alignment was accurate in 100% of patients. The accuracy of femoral component and tibial component sizing is statistically significant (Chi-squared test, p value 0.0105 and 0.0461, respectively).

Conclusion

The study results show the effectiveness of pre-operative 3 D CT scan planning in predicting the implant sizes and implant positioning. This may have a potential to improve the implant longevity, clinical outcomes and patient satisfaction.

中文翻译：

术前三维 (3D) CT 扫描模板在预测机器人辅助全膝关节置换术中准确植入物尺寸和对准方面的功效

背景

近20%的全膝关节置换术患者仍然不满意。这是二十一世纪关节成形术实践中的一个主要问题。准确的植入物尺寸被证明可以改善植入物的存活率、膝关节平衡和患者报告的结果。当前研究的目的是评估机器人辅助 TKA 中术前三维 (3D) CT 扫描模板在预测正确的种植体尺寸和对齐方面的效果。

材料和方法

对单个中心 30 个 RA-TKA 前瞻性收集的数据进行了评估。纳入标准是接受初次 TKA 的终末期关节炎（骨关节炎和类风湿关节炎）患者。接受翻修 TKA 的患者和不愿意参加该研究的患者被排除在外。对 10 名患者的初步研究表明，确定种植体尺寸和位置的准确性几乎为 100%。样本量估计为 28，种植体尺寸和位置误差减少 90%，α误差为 0.05，β 误差为 0.20，研究功效为 80。术后 X 线照片由独立观察员评估种植体尺寸和位置。位置。通过卡方检验将研究中股骨和胫骨部件尺寸的准确性与历史对照进行比较。p值 < 0.05被认为是显着的。