Comparable clinical outcomes in functionally aligned computer-assisted and image-based robotic assisted total knee...

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Biomechanical Engineering

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
• Advancements in surgical navigation and robotics aim to improve TKA outcomes.
• Functional alignment (FA) principles and patient-specific techniques are increasingly adopted in TKA.

Purpose of the Study:

• To compare clinical outcomes and complications between computer-aided surgery (CAS) and robotic-assisted (RA) posterior stabilised (PS) total knee arthroplasty (TKA).
• To evaluate the efficacy of TKA performed with FA principles and tibial pre-cut at a minimum 4-year follow-up.

Main Methods:

• Retrospective, monocentric, observational study of 94 patients undergoing PS TKA with CAS or RA following FA principles.
• Patients were assessed using the Forgotten Joint Score-12 (FJS-12), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR), and 5-Level Likert Scale (5-LLS).
• Minimum 4-year follow-up with radiological and clinical evaluations.

Main Results:

• 84 patients (40 CAS, 44 RA) were analyzed after exclusions.
• No revisions were performed in either group, achieving 100% Kaplan-Meier survivorship.
• No statistically significant differences were found between CAS and RA groups for FJS-12, KOOS-JR, or 5-LLS scores at follow-up.

Conclusions:

• Computer-aided surgery and robotic-assisted total knee arthroplasty demonstrate comparable clinical outcomes and complication profiles.
• Both CAS and RA techniques, when applied with patient-specific FA principles and a soft tissue-preserving approach, yield excellent results in PS-TKA.
• The choice between CAS and RA may not significantly impact patient-reported outcomes at a minimum 4-year follow-up.