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J Knee Surg 2022; 35(09): 1010-1018
DOI: 10.1055/s-0040-1721412
Original Article

Effect of Manual versus Robotic-Assisted Total Knee Arthroplasty on Cervical Spine Static and Dynamic Postures

Laura Y. Scholl
1   Department of Orthopaedics, Stryker, Mahwah, New Jersey
,
Emily L. Hampp
1   Department of Orthopaedics, Stryker, Mahwah, New Jersey
,
Vincent Alipit
1   Department of Orthopaedics, Stryker, Mahwah, New Jersey
,
Nipun Sodhi
2   Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York
,
Manoshi Bhowmik-Stoker
1   Department of Orthopaedics, Stryker, Mahwah, New Jersey
,
Jonathan Dropkin
3   Department of Occupational Medicine, Northwell Health, Great Neck, New York
,
Antonia F. Chen
4   Department of Orthopaedic Surgery, The Rothman Institute, Philadelphia, Pennsylvania
,
Michael A. Mont
5   Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York
› Author Affiliations Funding None.
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Abstract

This study compared surgeon cervical (C) spine postures and repetitive motions when performing traditional manual total knee arthroplasty (MTKA) versus robotic-assisted TKA (RATKA). Surgeons wore motion trackers on T3 vertebra and the occiput anatomical landmarks to obtain postural and repetitive motion data during MTKA and RATKA performed on cadavers. We assessed (1) flexion–extension at T3 and the occiput anatomical landmarks, (2) range of motion (ROM) as the percentage of time in the flexion–extension angle, (3) repetition rate, defined as the number of the times T3 and the occiput flexion-extension angle exceeded ±10°; and (4) static posture, where T3 or occiput postures exceed 10° for more than 30 seconds. The average T3 flexion–extension angle for MTKA cases was 5-degree larger than for RATKA cases (19 ± 8 vs. 14 ± 8 degrees). The surgeons who performed MTKA cases spent 15% more time in nonneutral C-spine ROM than those who performed RATKA cases (78 ± 25 vs. 63 ± 36%, p < 0.01). The repetition rate at T3 was 4% greater for MTKA than RATKA (14 ± 5 vs. 10 ± 6 reps/min). The percentage of time spent in static T3 posture was 5% greater for overall MTKA cases than for RATKA cases (15 ± 3 vs. 10 ± 3%). In this cadaveric study, we found differences in cervical and thoracic ergonomics between manual and robotic–assisted TKA. Specifically, we found that RATKA may reduce a surgeon's ergonomic strain at both the T3 and occiput locations by reducing the time the surgeon spends in a nonneutral position.

Keywords

knee arthroplasty - kinematics and kinetics - robotics - surgical ergonomics


Publication History

Received: 02 October 2020

Accepted: 17 October 2020

Article published online:
28 January 2021

© 2021. Thieme. All rights reserved.

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