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Orthopedic Robot-Assisted Femoral Neck System in the Treatment of Femoral Neck Fracture

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Does Robotic-Assisted Functional Knee Positioning Result in Better Functional Outcomes One Year After Surgery.

Matthew L Magruder¹, Emily Hampp², Melanie Caba²

¹Department of Orthopaedic Surgery, Maimonides Health, Brooklyn, New York.

Surgical Technology International

|June 20, 2025

Summary

Functional knee positioning (FP-TKA) in robotic-assisted total knee arthroplasty shows improved function at one year compared to mechanical alignment (MA-TKA). FP-TKA also resulted in a shorter hospital stay, suggesting personalized implant positioning benefits patients.

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Area of Science:

Orthopedic Surgery
Robotics in Medicine
Biomechanical Engineering

Background:

Robotic-assisted total knee arthroplasty (TKA) enables individualized implant placement using functional knee positioning (FKP).
This study compares patient-reported outcomes between mechanically aligned TKA (MA-TKA) and functionally positioned TKA (FP-TKA).

Purpose of the Study:

To compare patient-reported outcome measures (PROMs) between MA-TKA and FP-TKA.
To evaluate functional recovery, pain, range of motion, and length of stay following TKA.

Main Methods:

145 propensity score-matched pairs of MA-TKA and FP-TKA patients were analyzed from an institutional dataset.
FP-TKA involved individualizing implant position to balance the knee, minimizing soft tissue release.
MA-TKA utilized standard mechanical alignment and gap balancing techniques. Outcomes measured included r-WOMAC scores, length of stay (LOS), and range of motion.

Main Results:

No significant difference in r-WOMAC pain or function at six months, though FP-TKA trended favorably.
At one year, FP-TKA showed significantly improved function scores (2.94 vs. 4.38; p=0.02) compared to MA-TKA.
FP-TKA cohort had a shorter LOS (1.75 vs. 2.36 days; p<0.0001); no significant differences in knee flexion or extension at six weeks.

Conclusions:

FP-TKA demonstrated functional improvements at one year, potentially due to minimized dissection and personalized implant positioning.
While not reaching minimal clinically important difference, the trend suggests FP-TKA may enhance patient outcomes.
Robotic-assisted FKP may offer advantages in functional recovery and hospital resource utilization in TKA.