Related Experiment Video
Updated: Jan 11, 2026
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Inter- and intra-operator variability in ligament balance measurements in total knee arthroplasty with the robotic
Johnatan Everaert1,2, Esfandiar Chahidi3, Maarten Ulrix4
1Université Libre de Bruxelles, Brussels, Belgium. johnatan_everaert@hotmail.com.
Purpose:
This study quantifies the reproducibility of soft tissue laxity and gap measurements under manual stress, and implant positioning planning using the imageless ROSA® robotic system, by comparing a senior high-volume surgeon with a low-volume resident.
Methods:
In this single-centre prospective study, 17 patients undergoing robotic-assisted total knee arthroplasty were evaluated. Intra- and inter-operator variability was assessed by recording intraoperative measurements and planning outcomes using a standardized protocol for functional alignment (FA).
Results:
Both intra and inter-operator analyses demonstrated good to excellent reproducibility (ICC > 0.75-0.9) for soft tissue and gap assessments. Minor variability was observed in planning parameters (ICC < 0.60), specifically stylus height, femoral flexion, and distal femoral resection, likely reflecting subjective adjustments by the high-volume surgeon.
Conclusion:
High reproducibility in soft tissue measurements and surgical planning across surgeons with different experience levels is shown by the ROSA® robotic system, while flexibility for individualized surgical strategies is retained.
