High accuracy of a new robotically assisted technique for total knee arthroplasty: an in vivo study

Knee Surg Sports Traumatol Arthrosc. 2022 Jan 4;1-9. doi: 10.1007/s00167-021-06800-8. Online ahead of print.


Purpose: Over the last decade, robotic TKA gained popularity for improving the accuracy of implant positioning and reducing outliers in limb alignment comparing to conventional jig-based TKA. Hypothesis of this study was that this newly designed robotically assisted system will achieve a high level of accuracy for bone resection. Purpose of the study was to evaluate the accuracy of the system.

Methods: For this study, 75 knees in 75 patients were operated using a new, robotic system (ROSA® Knee System; Zimmer Biomet, Warsaw, IN) with a Posterior Stabilized Total Knee Arthroplasty (Persona® Knee System). The planned, validated and measured angles and cuts for the distal and posterior femur, for the proximal tibia and for the final coronal alignment on long standing x-rays were compared.

Results: A statistically significant difference was found only between the average planned and the average validated angle for femoral flexion, tibial coronal axis, medial and lateral cuts; the average difference was in any case below 1 mm or under 1 degree with SD < 1. No statistical difference was found between planned validated and measured cuts. Average difference between planned HKA and measured was 1.2 ± 1.1. No statistically significant difference was found.

Conclusions: The results of this study demonstrated that using this new surgical robot in total knee arthroplasty it is possible to perform accurate bone cuts and to achieve the planned angles and resections.

Keywords: Accuracy; Computer assisted surgery; In vivo; Navigation; Robotic surgery; Total knee arthroplasty.