Image-Free Robotic-Assisted Total Knee Arthroplasty Improves Implant Alignment Accuracy: A Cadaveric Study

Area of Science:

• Orthopedic Surgery
• Medical Robotics
• Biomechanical Engineering

Background:

• Improving resection accuracy in total knee arthroplasty (TKA) is crucial for patient outcomes.
• Robotic-assisted systems enhance accuracy and reproducibility over conventional methods.
• Image-free robotic systems utilize intraoperative landmarks, differing from those requiring preoperative imaging.

Purpose of the Study:

• To evaluate the alignment accuracy of a novel image-free robotic-assisted surgical system.
• To compare the robotic system's accuracy against conventional instrumentation in TKA.
• To determine if the robotic system reduces outliers in bone resection.

Main Methods:

• Forty cadaveric specimens underwent bilateral TKAs.
• Five surgeons used both the VELYS Robotic-Assisted System and conventional instruments on contralateral knees.
• CT and optical scans quantified resection accuracy relative to intraoperative alignment targets.

Main Results:

• Robotic assistance showed significantly smaller errors in femoral coronal, femoral sagittal, and tibial coronal alignments.
• Improvements were also noted in femoral implant coronal and sagittal, and tibial implant coronal alignments with robotic use.
• The robotic-assisted group exhibited fewer outliers (errors >3°) across all angular resections.

Conclusions:

• Image-free robotic-assisted TKA demonstrates superior alignment accuracy compared to conventional instrumentation.
• The use of this robotic system can decrease the incidence of outliers in TKA procedures.
• Robotic assistance offers a promising advancement for improving TKA precision and consistency.