Robotic Total Knee Replacement: Single-Centre, Prospective, Non-Randomised Comparative Study Comparing Restricted...

Area of Science:

• Orthopedic Surgery
• Robotic Surgery
• Biomedical Engineering

Background:

• Total knee arthroplasty (TKA) effectively treats end-stage knee arthritis but up to 20% of patients report dissatisfaction.
• Suboptimal limb alignment and ligament imbalance are potential causes for TKA dissatisfaction.
• Robotic assistance offers personalized approaches to TKA, aiming to improve outcomes.

Purpose of the Study:

• To compare clinical outcomes between two robotic-assisted TKA techniques: functional alignment (FA) and restricted kinematic alignment with a load sensor (rKA/sensor).
• To evaluate patient-reported outcomes including the 2011 Knee Society Score (KSS) and Forgotten Joint Score (FJS) at one year post-operatively.

Main Methods:

• A single-center, prospective, comparative study involving 43 patients in the FA group and 47 in the rKA/sensor group.
• Clinical outcomes assessed at 1 month and 1 year, including VAS pain, flexion, ROM, KSS, and FJS.
• Robotic-assisted bone re-cutting with a load sensor for ligament balancing in the rKA/sensor group.

Main Results:

• No statistically significant differences were found in 2011 KSS or FJS at 1 year between the FA and rKA/sensor groups.
• Multivariate analysis revealed no independent association of either technique with KSS scores (Objective Knee Indicators, Patient Satisfaction, Patient Expectations, Functional Activities) or FJS.
• All measured outcomes showed no significant differences between the two robotic-assisted TKA techniques.

Conclusions:

• Robotic-assisted FA TKA and rKA/sensor TKA demonstrate comparable clinical outcomes at one year post-operatively.
• This study is the first to compare these specific robotic-assisted TKA techniques.
• Larger studies are recommended to validate these findings and avoid potential type 2 errors.