Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for Knee Arthroplasty in Bi-Cruciate Retaining Total Knee Replacement

Abstract

Bi-cruciate retaining knee implants are anatomically designed for use in early surgical intervention, for patients with less severe arthritic disease. Patient satisfaction after total knee replacement is directly related to knee stability and proprioception, particularly for high-demand, active patients. While preservation of all intact and healthy ligaments may be the key to achieving such results of satisfaction, balancing four ligaments in a bi-cruciate procedure is more technically challenging then a conventional total knee replacement. Robotics-assisted arthroplasty has been gaining popularity as a tool to increase accuracy and precision of implant positioning. Robotics-assisted systems can provide surgeons with virtual tools to make informed decisions for knee replacement, specific to the needs of the patient. Here, we are introducing a semiautonomous handheld robotic system support for a bi-cruciate retaining knee implant design. The system supports image-free anatomic data collection and streamlined intraoperative surgical planning with dynamic gap balancing before any bone preparation. In this study, we evaluate the surgical technique and accuracy of implant placement in synthetic bone and cadaver experiments.