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Low revision rates, increased control of surgical factors reported with robotics to perform UKR

Issue: June 2013

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TORONTO — Orthopaedic surgeons today can choose from an array of metal and biological options for patients with early osteoarthritis or bipolar chondral wear and malalignment. However, in a presentation at The International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine Congress, Andrew D. Pearle, MD, said he prefers unicondylar knee replacement because it “resurfaces” the joint and helps realign it.

“I think there is potentially a huge cost savings when you use unicondylar knee replacement (UKR) as opposed to total knee replacement,” Pearle said, here.

 

Andrew D. Pearle

Pearle said he uses robotics because there is little control over patient factors and fixation, so he sought to improve his control over other variables. He selected a hepatic-guided robotic system for UKR cases to improve outcomes. In some instances, it has resulted in less overcorrection and “improved control over lower limb alignment,” Pearle said, noting 96% of medial cases among 600 cases done with robotics in the last 6 years were not overcorrected.

The “virtual” trialing, preoperative planning with static CT and accuracy of implant placement makes it “almost look like they’re machined into place,” he said when he showed a series of postoperative UKR radiographs. Furthermore, a study by Pearle and colleagues with 2-year follow-up in about 300 patients showed revision rates less than 1%, he said.

UKR performed this way is a reliable and safe solution for the master athlete with bichondral wear with malalignment, Pearle said. His goal is a return to work in 2 weeks for these patients. “My data are showing a more ‘forgotten joint’ as a result of this procedure vs. total knee replacement,” Pearle said.

Reference:

Pearle A. Symposium: Biological vs. metal solutions for early osteoarthritis: A case-based approach. Presented at: The International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine Congress; May 12-16, 2013; Toronto.

Disclosure: Pearle has no relevant financial disclosures.