Unsatisfactory accuracy of recent robotic assisting system ROSA for total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Robotic Surgery
• Medical Device Technology

Background:

• Total knee arthroplasty (TKA) is a common orthopedic procedure.
• Robotic-assisted surgical systems are increasingly being adopted to improve surgical precision.
• Evaluating the accuracy of these robotic systems is crucial for their clinical implementation.

Purpose of the Study:

• To quantify the accuracy of a recently FDA-approved robotic-assisted device, the Robotic Surgical Assistant (ROSA), in total knee arthroplasty.
• To compare intra-operative mechanical axis measurements with post-operative implant angles.

Main Methods:

• Thirty-seven patients underwent TKA using the ROSA system.
• Intra-operative angles (alpha, beta, gamma, delta, HKA) were calculated by ROSA.
• Post-operative angles were measured from X-rays and compared to the intra-operative plan.

Main Results:

• ROSA accurately calculated hip-knee-ankle (HKA), alpha (α), and beta (β) angles.
• Accuracy for HKA, α, and β angles within ±3° was 89%, 100%, and 92% respectively.
• Gamma (γ) and delta (δ) angles showed lower accuracy (77% and 74% within ±3°).

Conclusions:

• The ROSA system accurately predicts coronal plane resections in TKA.
• The system demonstrates deficiencies in predicting sagittal plane resections.
• Further investigation into these sagittal plane inaccuracies is warranted to assess the overall efficacy of robotic-assisted TKA.