4.4 Article

Personalized alignment™ for total knee arthroplasty using the ROSA® Knee and Persona® knee systems: Surgical technique

Journal

FRONTIERS IN SURGERY
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fsurg.2022.1098504

Keywords

kinematic alignment; orthopedic technology; restricted kinematic alignment; total knee arthroplasty; robotic assisted; rosa; personalized alignment

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The number of Total knee arthroplasty (TKA) procedures is expected to increase significantly in the United States. Traditional TKA procedures have limitations in restoring full knee function, leading to patient dissatisfaction. Kinematic alignment (KA) can restore the natural knee anatomy but may increase implant stress and risk of complications. Restricted kinematic alignment (rKA) techniques can improve patient outcomes. Personalized Alignment (TM) is an advanced version of rKA that uses robotic assistance to recreate patient anatomy and improve clinical outcomes.
Total knee arthroplasty (TKA) procedures are expected to increase up to 565% in the United States over the next 3 decades. TKAs were traditionally performed with neutral mechanical alignments that provided equal medial and lateral gaps in extension and flexion to reduce implant wear but were less successful at restoring native knee function and associated with high patient dissatisfaction. Kinematic alignment (KA) restores native anatomy and minimizes soft tissue release; however, KAs that recreate severe deformities and/or biomechanically inferior alignments result in significant increases in implant stress and risk of aseptic loosening. Restricted kinematic alignment (rKA) recreates pre-arthritic anatomy within a range of acceptable alignment boundaries, and improved patient clinical scores and faster recoveries have been reported with rKA techniques. Personalized Alignment (TM) is an evolution of rKA that relies heavily upon robotic assistance to reliably recreate patient anatomy, native soft tissue laxity, and accurate component placement to improve patients' clinical outcomes. The purpose of this surgical technique report is to describe the Personalized Alignment TKA method using the ROSA((R)) Knee System and Persona((R)) The Personalized Knee((R)) implants. Herein we provide specific procedures for pre-operative planning, anatomical landmarking and evaluation, intra-operative planning and adjustment of resections and cuts, cut validation and soft tissue evaluation with robotic-assisted personalized TKA.

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