Aug 27 2013
During the 13th Annual Meeting of the International Society for Computer Assisted Surgery, a study presented by Dr. Jan Koenig demonstrated why APEX Robotic Technology™ (OMNIlife science, Inc., East Taunton, MA) continues to be an industry leading solution to achieve post-operative alignment accuracy in total knee arthroplasty (TKA).
It is not just effective in routine cases of osteoarthritis but also when managing large pre-operative deformity ("large" in this study is knee alignment of more than 10 degrees from neutral mechanical alignment in the coronal plane). For these more difficult cases Dr. Koenig's study showed consistent and reproducible mean post-operative alignment of less than 2 degrees in the coronal plane for these large deformity cases with the use of APEX Robotic Technology™.[1]
Achieving post-operative knee alignment less than 3 degrees from neutral alignment is widely recognized as resulting in increased implant survivorship and decreased chance of having a revision of the original surgery.[2] [3] More impressive may be the fact that the average surgery time for these large deformity cases added less than 5 minutes to the average surgery time for the control group which had no significant deformity.
"The fact that we can formulate a virtual surgical plan and then validate that plan's execution with an average of less than 5 minutes added per case with an extreme level of accuracy demonstrates the effectiveness of real time navigation and robotics for total knee replacement," notes Dr. Koenig.
One reason OMNI's APEX Robotic Technology™ (A.R.T.™) system is able to achieve such good post-operative leg alignment is through the precision of its robotic saw guide.[4] In Dr. Corey Ponder's study presented at the CAOS meeting, he demonstrated how the robotic cutting guide allows him to obtain significantly more accurate and repeatable bone cuts than can be achieved with manual instruments.[5] More accurate bone cuts have a practical value to Dr. Ponder because of a unique "Press Fit" optimization feature he utilizes within the A.R.T.™ software.
In some patients, surgeons select to use knee replacement implants that do not require bone cement. Instead of bone cement these implants use a porous metal backing that allows the bone to grow onto and into the surface of the implant binding it to the patient's bone. However, the effectiveness of these porous "bone friendly" surfaces is highly dependent on a tight and intimate fit of the implant to the cut surfaces of the bone, hence the term "Press Fit". The robotic cutting guide allows the surgeon to make adjustments of just fractions of a millimeter to the cuts in real time during the surgery which may help adjust for differences in patients bone quality and achieve the desired component fit. Dr. Ponder stated, "It's a great benefit to be able to customize the dimensions of your bone cuts so that I can create the tightest fit possible for the implant. A.R.T.™ affords my patients and I that luxury."
APEX Robotic Technology™ is offered by OMNIlife science, Inc. as part of their computer-assisted total knee replacement platform. The A.R.T. system does not require a preoperative CT or MRI scan like other robotic systems or so called patient-specific instruments, avoiding the expense and radiation associated with these procedures. Instead, it uses a patient-specific computer model of the knee joint, generated through use of the company's patented Bone Morphing™ technology, to virtually plan all of the required bone cuts in real time during surgery.
About OMNIlife science, Inc.
OMNIlife science, Inc. was founded in 1999 as an organization committed to the design, manufacture and distribution of high quality orthopaedic devices. Our corporate headquarters are located in East Taunton, Massachusetts. Our products are prescribed by orthopaedic surgeons for their patients who require total joint replacement. OMNI is ISO 13485 certified and its products are FDA cleared and CE approved. We continue to challenge the design and functionality of our products based on continued advances in reconstructive surgical techniques, anatomic and biomechanical data, as well as input from surgeons.
[1] Koenig JA, Plaskos C: Influence of pre-operative deformity on surgical accuracy and time in robotic-assisted TKA, CAOS 2013
[2] Berend ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Faris GW, Davis KE; Tibial component failure mechanisms in total knee arthroplasty, Clin Orthop Relat Res. 2004 Nov;(428):26-34.
[3] Ritter MA, Faris PM, Keating EM, Meding JB; Postoperative alignment of total knee replacement. Its effect on survival, Clin Orthop Relat Res. 1994 Feb;(299):153-6.
[4] D. Koulalis, P.F. O'Loughlin, C. Plaskos, D. Kendoff, M. Cross, A.D. Pearle; Sequential versus automated cutting guides in computer-assisted total knee arthroplasty, The Knee 18 2011 436-442
[5] Ponder CE, Plaskos C, Cheal EJ: Press fit total knee arthroplasty with a robotic cutting guide – proof of concept and initial clinical experience, CAOS 2013