Does Femoral Component Sizing Differ Between Robotic-Assisted Versus Manual Total Knee Arthroplasty?

Principal Investigator: Dr. Antonia Chen

Authors: Teja Polisetty, Daniel Lamanna, Prabhavi Denagamage, Art Malkani, Antonia Chen
Lay Abstract

Introduction:
Studies have demonstrated superior clinical outcomes when smaller or equivalent sized femoral components are utilized in primary total knee arthroplasty (TKA) relative to the tibial component. The purpose of this study is to compare femoral and tibial component sizes between manual and robotic-assisted TKA.

Methods:
Femoral and tibial component sizing were recorded from 4/2018-7/2021. A test of proportions with Fisher’s exact test was used to determine if the proportion of larger femurs was different between manual and robotic-assisted TKAs. A Fisher’s exact test was also used to determine an association between femoral component type and type of TKA.

Results:
For manual TKA, 55.5% had equal sized femoral and tibial components, 23.4% had smaller femoral components, and 21.1% had larger femoral components. For robotic-assisted TKA, 57.7% had equal sized components, 34.6% had smaller femoral components, and 7.7% had larger femoral components. While there were smaller femoral components utilized in robotic-assisted TKA, the difference was not significant (p=0.085).

Conclusion:
Robotic-assisted TKAs utilized a greater percentage of smaller femoral components relative to tibial components compared to manual TKAs. Further studies are needed to elucidate if these findings correlate to patient reported outcomes and long-term survivorship in manual versus robotic-assisted TKA.

Scientific Abstract

Introduction:
Studies have demonstrated superior clinical outcomes when smaller or equivalent sized femoral components are utilized in primary total knee arthroplasty (TKA) relative to the tibial component. The purpose of this study is to compare femoral and tibial component sizes between manual and robotic-assisted TKA.

Methods:
Femoral and tibial component sizing were recorded from 4/2018-7/2021. A test of proportions with Fisher’s exact test was used to determine if the proportion of larger femurs was different between manual and robotic-assisted TKAs. A Fisher’s exact test was also used to determine an association between femoral component type and type of TKA.

Results:
For manual TKA, 55.5% had equal sized femoral and tibial components, 23.4% had smaller femoral components, and 21.1% had larger femoral components. For robotic-assisted TKA, 57.7% had equal sized components, 34.6% had smaller femoral components, and 7.7% had larger femoral components. While there were smaller femoral components utilized in robotic-assisted TKA, the difference was not significant (p=0.085).

Conclusion:
Robotic-assisted TKAs utilized a greater percentage of smaller femoral components relative to tibial components compared to manual TKAs. Further studies are needed to elucidate if these findings correlate to patient reported outcomes and long-term survivorship in manual versus robotic-assisted TKA.

Clinical Implications
Studies demonstrate superior outcomes when smaller or equivalent sized femoral components are utilized in total knee arthroplasty (TKA) relative to the tibial component. Robotic-assisted TKAs used smaller femoral components relative to tibial components which can optimize surgical planning and execution.

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