Improved surgical accuracy in total knee arthroplasty using the ROSA® knee system: A randomised-controlled unblinded...

Area of Science:

• Orthopedic surgery
• Robotics in medicine
• Biomechanical engineering

Background:

• Robotic-assisted total knee arthroplasty (RATKA) shows potential for enhanced surgical precision and implant alignment over conventional TKA (CTKA).
• Limited randomized-controlled trial (RCT) evidence exists, and various robotic systems are available.
• This study compares the ROSA® knee system for RATKA against CTKA.

Purpose of the Study:

• To prospectively compare surgical and patient-reported outcomes of RATKA using the ROSA® knee system versus CTKA.
• To evaluate implant alignment accuracy and patient satisfaction.
• To assess secondary outcomes including range of motion and length of stay.

Main Methods:

• A monocentric, unblinded RCT included 77 patients undergoing TKA with a minimum 1-year follow-up.
• Primary endpoints: postoperative implant alignment, Oxford knee score (OKS), and EQ-5D-5L quality of life scores.
• Secondary endpoints: range of motion, blood loss, length of stay, return to work, and physiotherapy needs.

Main Results:

• RATKA demonstrated significantly improved limb alignment, with a lower frequency of extreme malalignment compared to CTKA (18% vs. 38%, p=0.047).
• Postoperative improvements in OKS and EQ-5D-5L scores were comparable between groups (p>0.05).
• Preoperative OKS and cruciate-retaining implant bearing were significant predictors of improved outcomes.

Conclusions:

• RATKA with the ROSA® knee system enhances implant positioning and radiological alignment compared to CTKA.
• Short-term clinical outcomes were similar between the two methods.
• Long-term RCT data are necessary to ascertain if improved RATKA accuracy translates to superior implant survival and reduced revision rates.