Surgical accuracy of image-free versus image-based robotic-assisted total knee arthroplasty

Int J Med Robot. 2023 Sep 6:e2574. doi: 10.1002/rcs.2574. Online ahead of print.

Abstract

Background: This study investigated the accuracy in achieving proper lower limb alignment and component positions after total knee replacement (TKR) with image-free and image-based robotic-assisted TKR.

Methods: A total of 129 patients (166 knees) suffering from end-stage knee arthritis who underwent TKA operated by robotic-assisted surgery between the years 2018 and mid-2021 were recruited. Radiological outcomes were compared between image-free and image-based robotic-assisted surgical systems.

Results: There were significant differences between the two robotic systems when comparing the mean planned component alignment and the mean measured alignment on radiographs, in which the image-free robotic-assisted system was more varus, whereas the image-based robotic-assisted system was more valgus for both the mean femoral and tibial component coronal alignment (p < 0.001). For tibial component sagittal alignment, the image-based group had a larger deviation from the planned posterior slope (p < 0.001).

Conclusion: Image-free and image-based robotic assisted TKR had differing accuracy in femoral and tibial alignment.

Keywords: joints; orthopaedic; robotic assisted surgery; total knee arthroplasty.