Robotic Assisted TKA achieves adjusted mechanical alignment targets more consistently compared to manual TKA without improving outcomes

Abstract

Abstract Introduction Robotic total knee arthroplasty (rTKA), with its purported advantages of more accurate alignment, greater functional outcomes and patient satisfaction, is gaining popularity in patients undergoing TKA. The purpose of our study was to compare these parameters along with gait pattern and kneeling ability in a cohort of patients who underwent simultaneous TKA with manual instrumentation (mTKA) and rTKA in contralateral knees at a 1‐year follow‐up. Methods This was a retrospective review of 135 consecutive patients who underwent simultaneous bilateral TKA using robotic assistance on one side and manual instrumentation on the contralateral side between January 2022 and June 2022. The target alignment in both cohorts was adjusted mechanical. Patients were followed up at 3, 6 and 12 months to assess and compare alignment, range of motion (ROM) and patient‐reported outcome measures (PROM) data. Gait parameters and kneeling ability were assessed at 1‐year follow‐up. Results While adjusted mechanical alignment was achieved in all rTKA patients, we recorded five outliers (≥3° with relation to 180° HKA axis) in the mTKA cohort (three varus and two valgus). There were no significant differences between both cohorts with regards to ROM, PROM scores, gait analysis parameters and kneeling ability at 1‐year follow‐up. Conclusion rTKA helps in achieving the adjusted mechanical alignment more consistently than mTKA. This, however, does not contribute to better functional outcomes and patient satisfaction at 1‐year follow‐up. Level of Evidence Level III.

Keywords

• conventional total knee arthroplasty
• gait analysis
• patient reported outcome measures
• range of motion
• robotic total knee arthroplasty