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Robotic-Assisted Kinematically Aligned Total Knee Arthroplasty.

Alex M Hollenberg1, Joseph T Gibian1, William A Zuke2

  • 1Orthopedic Surgery, Washington University School of Medicine, St. Louis, USA.

Cureus
|December 8, 2025
PubMed
Summary
This summary is machine-generated.

Robotic-assisted total knee arthroplasty (TKA) using kinematic alignment (KA) offers improved accuracy by mapping cartilage and guiding patient-specific component placement, potentially overcoming limitations of traditional methods.

Keywords:
cartilage mappingkinematic alignmentmechanical alignmentprimary total knee arthroplastyrobotic knee surgery

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Robotics in Medicine

Background:

  • Mechanical alignment (MA) is the traditional standard for total knee arthroplasty (TKA), aiming for neutral limb alignment.
  • Kinematic alignment (KA) aims to restore pre-arthritic joint geometry and soft-tissue balance.
  • Existing KA techniques have limitations due to cartilage assumptions and manual resection precision.

Purpose of the Study:

  • To present a surgical technique for robotic-assisted kinematically aligned TKA.
  • To address limitations of traditional KA by enhancing accuracy and reproducibility.
  • To leverage robotic technology for patient-specific component placement.

Main Methods:

  • Utilizing a CT-based robotic platform for intraoperative cartilage mapping.
  • Guiding patient-specific bone resections based on robotic data.
  • Applying robotic assistance to achieve kinematic alignment principles in TKA.
  • Performing objective soft-tissue balance assessment with robotic guidance.

Main Results:

  • Robotic assistance enhances accuracy and reproducibility in TKA implant placement.
  • Patient-specific bony resection planning is facilitated by robotic platforms.
  • Intraoperative mapping of intact cartilage improves precision of KA.
  • Potential for reduced intraoperative bony recuts due to improved soft-tissue balance assessment.

Conclusions:

  • Robotic-assisted KA TKA offers a more precise and reproducible approach compared to traditional methods.
  • This technique leverages advanced technology to overcome limitations of manual KA.
  • It enables restoration of native joint geometry and soft-tissue balance with enhanced accuracy.