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Updated: Oct 29, 2025

A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique

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Active robotic technologies for total knee arthroplasty.

Bernard N Stulberg¹, Jayson D Zadzilka²

¹St. Vincent Charity Medical Center, 33001 Solon Rd., Suite 112, Solon, OH, 44139, USA.

Archives of Orthopaedic and Trauma Surgery

|July 14, 2021

Summary

Active robotic systems for Total Knee Arthroplasty (TKA) demonstrate a safe and accurate approach. This study highlights the technology

Keywords:

Active robotics Kinematic alignment Mechanical alignment Open platform Total knee arthroplasty

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Area of Science:

Orthopedic surgery
Robotic surgery
Medical device technology

Background:

Renewed interest in robotic technologies for Total Knee Arthroplasty (TKA) follows initial skepticism.
Early TKA robotic systems did not show clear clinical outcome improvements over conventional methods.

Purpose of the Study:

To evaluate the safety and efficacy of an active robotic system (ARoS) for TKA.
To assess the accuracy of bone preparation and component placement using ARoS.

Main Methods:

The study involved 115 patients undergoing TKA using an ARoS in a US IDE trial (Feb 2017-Dec 2018).
Bone preparation was performed by a milling tool guided by CT-based preoperative plans.
Component placement accuracy was verified using 3-month postoperative CT scans.

Main Results:

No new safety issues were reported for TKA using the ARoS.
Autonomous resections achieved accuracy within 1.5 mm and/or 1.5 degrees compared to preoperative plans.
The ARoS facilitated both kinematic alignment (40 procedures) and mechanical alignment (75 procedures).

Conclusions:

This multicenter FDA study represents the first US experience with this active robotic TKA technology.
The ARoS demonstrated an excellent safety profile and high accuracy in component placement.
Active robotics offers standardization, device options, and consistent results, making it a viable and safe technique for primary TKA.