Archives of Orthopaedic and Trauma Surgery - 2026-05-06 - Journal Article; Multicenter Study; Comparative Study
Short-term clinical outcomes of robotic-assisted total knee arthroplasty at 12-month follow-up: a prospective, multicenter, concomitant comparison to conventional total knee arthroplasty.
Nöth U, Rivkin G, Caldora P, Heller KD, Thienpont E, Hannouche D, Perets I, Cholewa J
Topics
Key Takeaway
Robotic-assisted TKA required soft tissue releases in only 23.3% of cases versus 51.5% with conventional TKA (p<0.0001), but produced equivalent OKS, FJS-12, and overall satisfaction at 12 months.
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Summary
This non-randomized controlled trial compared 12-month outcomes of a cut-block positioning robotic system versus conventional TKA across 6 centers. raTKA significantly reduced soft tissue releases (23.3% vs 51.5%, p<0.0001) and medial/lateral instability at 6 weeks and 3 months. At 12 months, overall satisfaction (96.3% vs 92.5%), OKS, FJS-12, and EQ-5D-5L were equivalent between groups, with the statistically significant EQ-5D-5L difference (0.529 vs 0.417) not exceeding the MCID.
Key Limitation
Non-randomized design with no reported correction for baseline deformity severity, BMI, or surgeon case volume, making it impossible to exclude case-mix bias as the driver of the soft tissue release difference.
Original Abstract
INTRODUCTION
There is limited data available on short-term outcomes on a cut-block positioning robotic system. The purpose of this study was to compare 12-month clinical outcomes between robotic-assisted (raTKA) and conventional total knee arthroplasty (cTKA) with multiple outcomes and surgical centers.
METHODS
This was a non-randomized controlled trial of patients who received either raTKA (n = 120) or cTKA (n = 101) at 6 different surgical centers. Variables of interest included occurrence of soft tissue release, complications and revisions at minimum one-year follow-up. Satisfaction, pain (numeric rating scale [NRS]), 5-dimensional European Quality of Life (EQ-5D-5 L) questionnaire (index and visual analog scale [VAS]), Oxford Knee Score (OKS), and the Forgotten Joint Score (FJS-12) were collected pre-operatively, and at six weeks, three months, and 12 months post-operative.
RESULTS
There were significantly less soft tissue releases with raTKA (28/120, 23.3%) vs. cTKA (51/99, 51.5%), p < 0.0001). There were significantly fewer cases of medial/lateral instability in the raTKA group at six-weeks (p = 0.038) and three-months (p = 0.007) post-operative. At one-year follow-up, 96.3 and 92.5% of raTKA and cTKA patients were satisfied with the overall results of their surgery, respectively. Significantly more raTKA patients were very satisfied (32.1% vs. 14.6%) with their ability to do home/yard work at six weeks (p = 0.018). Significantly (p = 0.042) less raTKA patients were dissatisfied (5.1% vs. 12.9%) with their ability to perform recreation at one-year post-operative. The EQ-5D-5 L increased significantly (p = 0.042) more in the raTKA group at one-year post-operative (0.529 ± 0.335 vs. 0.417 ± 0.323), but did not exceed the minimal clinical important difference.
CONCLUSION
raTKA was associated with fewer soft tissue release procedures and medial/lateral instability with greater satisfaction in performing home/yard work at six-weeks post-operative. raTKA was equivalent to cTKA for overall satisfaction, quality of life, and knee-specific patient reported outcome measures in the early post-operative period.
LEVEL OF EVIDENCE
II.