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Radiographic Accuracy and Consistency of Implant Placement Using the ROSA® Knee System in Robotic-Assisted Total Knee
Wai Kit Wong1, Naim Che-Kamaruddin2, Siti Zubaidah Zulkhairi2
1Orthopaedic Centre of Excellence, Sunway Medical Centre, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia.
Life (Basel, Switzerland)
|June 26, 2026
Summary
Robotic-assisted total knee arthroplasty using the ROSA Knee System demonstrates precise implant positioning and reliable restoration of the hip-knee-ankle (HKA) axis. Surgeon proficiency leads to consistent outcomes with no increased complication risks.
Area of Science:
- Orthopedic Surgery
- Robotics in Medicine
- Biomechanical Engineering
Background:
- Robotic systems are increasingly integrated into knee arthroplasty, showing promise for enhanced precision.
- The ROSA Knee System aids in robotic-assisted positioning and real-time ligament balance assessment during total knee arthroplasty.
- Surgeons maintain control over bone resections while utilizing robotic assistance.
Purpose of the Study:
- To evaluate the precision of implant positioning in robotic-assisted total knee arthroplasty (RATKA).
- To assess the achievement of the planned hip-knee-ankle (HKA) axis.
- To determine the consistency of outcomes across different operating surgeons using the ROSA Knee System.
Main Methods:
- A prospective observational study involving patients undergoing RATKA with the ROSA Knee System.
- Radiographic assessments included pre- and post-operative knee and long-limb views, with post-operative CT for femoral rotation.
- Comparison of intra-operative alignment data from the ROSA console with post-operative imaging and evaluation of complication rates.
Main Results:
- Ninety-four knees were analyzed, showing statistically significant differences between intra-operative and post-operative HKA measurements (1.66 ± 2.09°).
- Minor but significant differences were found in LDFA (0.32 ± 1.84°), MPTA (0.84 ± 1.17°), and femoral component rotation (1.63 ± 2.40°).
- While LDFA and MPTA showed no significant inter-surgeon variation, rotational alignment and HKA exhibited differences; intra-operative HKA correlated moderately with post-operative HKA and aHKA.
Conclusions:
- The ROSA Knee System facilitates reproducible and accurate implant positioning in total knee arthroplasty.
- Reliable restoration of the planned hip-knee-ankle (HKA) axis is achievable with robotic assistance.
- Surgeon proficiency with the ROSA Knee System leads to consistent results without elevating complication risks.
