Initial Experience with the NAVIO Robotic-Assisted Total Knee Replacement-Coronal Alignment Accuracy and the Learning...

Area of Science:

• Orthopedic Surgery
• Robotics in Medicine
• Biomechanical Alignment

Background:

• Restoring the lower limb's mechanical axis is crucial for total knee arthroplasty (TKA) success.
• Maintaining coronal alignment within 3 degrees of neutral improves clinical outcomes and implant survival.
• Robotic-assisted surgery (RAS) systems offer potential for enhanced precision in component placement.

Purpose of the Study:

• To evaluate the efficacy of a robotic-assisted system for coronal plane component positioning in TKA.
• To assess the learning curve associated with adopting RAS technology for TKA.

Main Methods:

• A single surgeon performed 72 TKAs using an RAS system between November 2017 and September 2018.
• Preoperative and postoperative coronal weight-bearing alignments were measured.
• Intraoperative robotic registration data and procedure duration were collected to analyze the learning curve.

Main Results:

• 93.3% of TKAs achieved the target coronal alignment within 3 degrees of neutral.
• Preoperative deformity was significantly greater in cases not achieving neutral alignment.
• Analysis of RAS usage time did not reveal a learning curve effect for the surgeon.

Conclusions:

• The robotic-assisted system demonstrated high accuracy (>93%) in achieving neutral coronal alignment in TKA.
• The adoption of RAS technology for TKA showed no discernible learning curve effect.
• The RAS system is presented as an easily adopted, safe, and accurate tool for TKA component positioning.