A literature review of robotic systems showed that these systems can , similarly to computer navigation , reliably improve lower leg alignment , component positioning and soft tissues balancing .
Findings in this study suggest that computer navigation or robotic assistance may help managing these multiple variables and could improve outcomes .
Recently , there is a growing interest in surgical variables that are intraoperatively controlled by orthopaedic surgeons , including lower leg alignment , component positioning and soft tissues balancing .
Since more tight control over these factors is associated with improved outcomes of unicompartmental knee arthroplasty and total knee arthroplasty ( TKA ) , several computer navigation and robotic-assisted systems have been developed .
Although mechanical axis accuracy and component positioning have been shown to improve with computer navigation , no superiority in functional outcomes has yet been shown .
This could be explained by the fact that many differences exist between the number and type of surgical variables these systems control .
Most systems control lower leg alignment and component positioning , while some in addition control soft tissue balancing .
Finally , robotic-assisted systems have the additional advantage of improving surgical precision .
Manually controlling all these surgical variables can be difficult for the orthopaedic surgeon .
Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA
Background Several studies have shown mechanical alignment influences the outcome of TKA . Robotic systems have been developed to improve the precision and accuracy of achieving component position and mechanical alignment . Questions / purpose sWe determined whether robotic-assisted implantation for TKA ( 1 ) improved clinical outcome ; ( 2 ) improved mechanical axis alignment and implant inclination in the coronal and sagittal planes ; ( 3 ) improved the balance ( flexion and extension gaps ) ; and ( 4 ) reduced complications , postoperative drainage , and operative time when compared to conventionally implanted TKA over an intermediate-term ( minimum 3-year ) followup period . Methods We prospect ively r and omized 100 patients who underwent unilateral TKA into one of two groups : 50 using a robotic-assisted procedure and 50 using conventional manual techniques .  Outcome variables considered were postoperative ROM , WOMAC scores , Hospital for Special Surgery ( HSS ) knee scores , mechanical axis alignment , flexion/extension gap balance , complications , postoperative drainage , and operative time . Minimum followup was 41 months ( mean , 65 months ; range , 41–81 months ) . Results There were no differences in postoperative ROM , WOMAC scores , and HSS knee scores . The robotic-assisted group result ed in no mechanical axis outliers ( > ± 3 ° from neutral ) compared to 24 % in the conventional group . There were fewer robotic-assisted knees where the flexion gap exceeded the extension gap by 2 mm . The robotic-assisted procedures took an average of 25 minutes longer than the conventional procedures but had less postoperative blood drainage . There were no differences in complications between groups . Conclusions Robotic-assisted TKA appears to reduce the number of mechanical axis alignment outliers and improve the ability to achieve flexion-extension gap balance , without any differences in clinical scores or complications when compared to conventional manual techniques . Level of Evidence Level I , therapeutic study . See Instructions for Authors for a complete description of levels of evidence
A literature review of robotic systems showed that these systems can , similarly to computer navigation , reliably improve lower leg alignment , component positioning and soft tissues balancing .
Findings in this study suggest that computer navigation or robotic assistance may help managing these multiple variables and could improve outcomes .
Recently , there is a growing interest in surgical variables that are intraoperatively controlled by orthopaedic surgeons , including lower leg alignment , component positioning and soft tissues balancing .
Since more tight control over these factors is associated with improved outcomes of unicompartmental knee arthroplasty and total knee arthroplasty ( TKA ) , several computer navigation and robotic-assisted systems have been developed .
Although mechanical axis accuracy and component positioning have been shown to improve with computer navigation , no superiority in functional outcomes has yet been shown .
This could be explained by the fact that many differences exist between the number and type of surgical variables these systems control .
Most systems control lower leg alignment and component positioning , while some in addition control soft tissue balancing .
Finally , robotic-assisted systems have the additional advantage of improving surgical precision .
Manually controlling all these surgical variables can be difficult for the orthopaedic surgeon .