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Robot assisted UKA a randomised trial

Robot assisted UKA a randomised trial. Justin Cobb Chair of Orthopaedics Imperial College London. Few 5mm slices through hips and ankles 1mm contiguous slices at knee. CT based planning. Novel registration algorithm. Hip centre 4 initial points 6 points in 5 zones.

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Robot assisted UKA a randomised trial

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  1. Robot assisted UKAa randomised trial Justin Cobb Chair of Orthopaedics Imperial CollegeLondon

  2. Few 5mm slices through hips and ankles 1mm contiguous slices at knee CT based planning

  3. Novel registration algorithm • Hip centre • 4 initial points • 6 points in 5 zones

  4. On screen feedback more helpful than direct vision

  5. Rest of operation is routine

  6. Results • Prospective Randomised Controlled Trial • Ethics committee approved • Conventional mis uka by one of 4 surgeons • All had ct based planning • Surgeon showed what he was aiming at • Patients not told until after 6 week check • Imaging reported by blind assessor

  7. Post-op CT vs pre-op plan • Whole bone images co-registered • White = plan • Yellow = achieved • Combination of errors: • registration • bone prep • implantation

  8. Control examples cases 1,3

  9. Control Group

  10. Acrobot example 1

  11. Acrobot Group

  12. Blind assessment

  13. P<0.001 (Fischer’s exact t test) Acrobot much more accurate

  14. Correlate accuracy and AKS scores Correlation is significant, p=0.002

  15. Summary • 1MIS UKA will become the default operation for OA of the knee, whether medial, lateral or patello-femoral • 2 Meniscal bearing an excellent option • 3 Ct based modelling is an enabling technology

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