AI Article Synopsis
- The study compared robotic-arm assisted total knee arthroplasty (RA-TKA) to conventional jig-based total knee arthroplasty (CJ-TKA), focusing on the injury to bone and soft tissues during the procedures.
- Patients who underwent RA-TKA showed significantly less soft tissue damage and cleaner bone resection cuts compared to those who had CJ-TKA, with a newly developed classification system called MASTI effectively grading these injuries.
- The MASTI classification demonstrated strong reliability among different observers, indicating its potential use for standardizing how we report and understand surgical outcomes related to tissue injuries in knee surgeries.
Article Abstract
Background: The objective of this study was to compare macroscopic bone and soft tissue injury between robotic-arm assisted total knee arthroplasty (RA-TKA) and conventional jig-based total knee arthroplasty (CJ-TKA) and create a validated classification system for reporting iatrogenic bone and periarticular soft tissue injury after TKA.
Methods: This study included 30 consecutive CJ-TKAs followed by 30 consecutive RA-TKAs performed by a single surgeon. Intraoperative photographs of the femur, tibia, and periarticular soft tissues were taken before implantation of prostheses. Using these outcomes, the macroscopic soft tissue injury (MASTI) classification system was developed to grade iatrogenic bone and soft tissue injuries. Interobserver and Intraobserver validity of the proposed classification system was assessed.
Results: Patients undergoing RA-TKA had reduced medial soft tissue injury in both passively correctible (P < .05) and noncorrectible varus deformities (P < .05); more pristine femoral (P < .05) and tibial (P < .05) bone resection cuts; and improved MASTI scores compared to CJ-TKA (P < .05). There was high interobserver (intraclass correlation coefficient 0.92 [95% confidence interval: 0.88-0.96], P < .05) and intraobserver agreement (intraclass correlation coefficient 0.94 [95% confidence interval: 0.92-0.97], P < .05) of the proposed MASTI classification system.
Conclusion: There is reduced bone and periarticular soft tissue injury in patients undergoing RA-TKA compared to CJ-TKA. The proposed MASTI classification system is a reproducible grading scheme for describing iatrogenic bone and soft tissue injury in TKA.
Clinical Relevance: RA-TKA is associated with reduced bone and soft tissue injury compared with conventional jig-based TKA. The proposed MASTI classification may facilitate further research correlating macroscopic soft tissue injury during TKA to long-term clinical and functional outcomes.
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| http://dx.doi.org/10.1016/j.arth.2018.03.042 | DOI Listing |
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