title: Robot-assisted total knee arthroplasty in haemophilic arthropathy.
abstract: BACKGROUND
  Execution of total knee arthroplasty (TKA) in end-stage haemophilic arthropathy is challenging because of soft tissue fibrosis, flexion contractures, poor quality of the bone, and the altered bony anatomy. Restoring the lower limb alignment and achieving range of motion (ROM) is difficult. Robots have been used in TKA to reduce the chances of malalignment and improve accuracy and precision. However, there has been no report in literature on use of robots for TKA in haemophilic arthropathy. The aim of this study was to evaluate whether robot-assisted TKA can be successfully carried out in haemophilic arthropathy and what precision could be obtained.
  
  
  METHODS
  Thirty-two robot-assisted TKA were evaluated in 29 haemophilia patients. The mean follow up period was 5 years (range, 3-7 years). Hip-knee-ankle (HKA) axis, component angles, and radiographic loosening were evaluated. Clinically ROM, Knee Society scores (KSS) and SF-36 were assessed.
  
  
  RESULTS
  The HKA axis was within a range of 0 ± 3° in 30 knees (93.8%). The alignment of the components also presented satisfying results. KSS were improved from 27.1 to 82.8 postoperatively (P < 0.001). The ROM was improved from 70.7 to 84.7 postoperatively (P = 0.006). Complications included early haematoma in three knees, heterotopic ossification in three knees, periprosthetic infection in two knees.
  
  
  CONCLUSIONS
  Though robotic TKA gives excellent accuracy of lower limb and component alignment, expensive cost, additional preparation time, longer operation time with similar clinical results in haemophilic arthropathy should be concerned.
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: K-I
authors: KI
authors: Kim
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: D-K
authors: DK
authors: Kim
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: H-S
authors: HS
authors: Juh
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: S
authors: S
authors: Khurana
authors: Department of Orthopaedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors: K-H
authors: KH
authors: Rhyu
mesh_terms: D000328:Adult; D019645:Arthroplasty, Replacement, Knee; D005500:Follow-Up Studies; D006467:Hemophilia A / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D002836:Hemophilia B / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012371:Robotics; D012720:Severity of Illness Index
keywords: alignment; haemophilic arthropathy; robot-assisted; total knee arthroplasty