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

Abstract

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