Knee replacement surgery is a surgery designed to treat severe arthritis of the knee. However, as many as 20% of patients are not satisfied with the results of their surgery. To place the knee replacement in correct position, the kinematic alignment method, which tries to reproduce the patient normal anatomy, has shown promise in improving the satisfaction after knee replacement surgery. It is not known if using a robotic arm to assist in surgery is better than the traditional method when trying to recreate kinematic alignment. The goal of this study is to learn if robotic assisted surgery is better than traditional method for knee replacement done using kinematic alignment. The main questions the study tries to answer are: 1. Do the radiographs of kinematic knee replacement surgeries done with robotic assistance show better alignment than radiographs of kinematic knee replacements done with the traditional method? 2. Does robotic assisted kinematic knee replacement give better function to patients than traditional knee replacement done with kinematic alignment? 3. Does robotic assisted kinematic knee replacement decrease pain, improve knee movement and improve knee stability better than traditional knee replacement done with kinematic alignment? 4. Are there more complications with robotic assisted kinematic knee replacement in comparison to traditional kinematic knee replacement? 5. How long long does it take a surgeon to become good a performing a kinematic knee replacement using robotic assistance? Researchers will compare knee replacements done using a robotic to make the bone cuts, and compare it to the usual method using guides and manual instruments. All the knee replacements will be done using the kinematic alignment and with the same type of knee replacement prothesis. Participants will: * Have a knee replacement done with the kinematic alignment technique by an experienced surgeon, with or without robotic assistance during the surgery. * Visit the clinic before surgery, six weeks after surgery, three months, six months, twelve months and twenty-four months after the surgery. * Fill questionnaire, have their knee examined and have radiographs of their knee done at each visit.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
200
Replacement of worn knee cartilage using a prosthesis. The alignment is determined according to the patient's anatomy and ligament balance.
Radiographic alignment of the knee
Long leg anteroposterior views of both legs and lateral knee radiographs will be used to measure knee alignment and position of the knee replacement hardware. The angles measured and analyzed will be: * The hip-knee-ankle (HKA) angle * Medial proximal tibia mechanical angle (MPTAm) * Lateral distal femur mechanical angle (LDTAm) * Distal femur flexion angle (DFFA) * Posterior tibial slope (PTS) Radiographic measurements will be made by a trained observer and a fellowship-train arthroplasty surgeon.
Time frame: Pre-operative alignement and 6 months post-operative alignement.
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Patient questionnaire (42 questions) evaluating knee pain, symptoms, function, recreational activities and knee-related quality of life. The questionnaire is score over 100 points, with a higher score meaning better knee function.
Time frame: Pre-operative, 6 weeks, 6 months, 12 months, 24 months post-operative
Forgotten joint score
A 12-questions form asking patients if they forget about their joint during activities of daily living.
Time frame: Pre-operative, 6 weeks, 6 months, 12 months and 24 months post-op
Joint perception question
A single item question asking participants how they perceive their operated knee, from "like a native or natural joint" to "like a nonfunctional joint".
Time frame: Pre-operative, 6 weeks, 6 months, 12 months and 24 months post-operative
Pain visual analog scale
Pain rated on a 10 cm visual analog scale from "no pain" to "worst pain imaginable"
Time frame: Pre-op, 6 weeks, 6, 12, 24 months
Subjective Assessment Numeric Evaluation Scale (SANE)
Single question evaluation scale asking the patient to rate their knee function from 0 (no function) to 100 (completely normal function)
Time frame: Pre-op, 6 weeks, 6, 12, 24 months
Knee range of motion
Maximum passive flexion and extension measured with goniometer
Time frame: Pre, 6 weeks, 6 and 12 months post-op
Knee stability
Anterior drawer, posterior drawer, valgus stress, varus stress. Instability rated for each test 1 to 3 by treating surgeon.
Time frame: Pre-op, 6 weeks, 6 and 12 months post-op
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