Improved Component Placement Accuracy with Robotic-Arm Assisted Total Knee Arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Robotics

Background:

• Component positioning in total knee arthroplasty (TKA) significantly impacts prosthetic survivorship and clinical outcomes.
• Achieving precise component placement is crucial for successful TKA outcomes.

Purpose of the Study:

• To compare the three-dimensional accuracy of robotic-arm assisted TKA (RATKA) with conventional TKA in achieving planned component positions.
• To evaluate the clinical outcomes and functional improvements associated with RATKA versus conventional TKA.

Main Methods:

• A nonrandomized, prospective study involving 143 RATKA and 86 conventional TKA procedures across four U.S. centers.
• Postoperative CT scans were analyzed for absolute deviations from planned femoral and tibial component alignment, rotation, and slope.
• Patient-reported outcome measures (VR-12, KS scores) were collected and analyzed using multivariable regression.

Main Results:

• RATKA demonstrated significantly greater accuracy in tibial component alignment (p < 0.001) and tibial slope (p < 0.001) compared to conventional TKA.
• RATKA also showed improved accuracy in femoral component rotation (p = 0.015).
• Patients undergoing RATKA reported significantly better VR-12 physical component scores (p = 0.034) and showed a trend towards improved KS functional scores.

Conclusions:

• Robotic-arm assisted TKA provides superior three-dimensional accuracy for component positioning compared to conventional instrumentation.
• RATKA is associated with enhanced clinical outcomes, including improved physical status and function, with no increased safety concerns.
• The findings support the adoption of RATKA for optimizing total knee arthroplasty results.