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 .
Computer navigation versus conventional total knee replacement: no difference in functional results at two years.
We previously compared the component alignment in  total knee replacement  using a computer-navigated technique with a conventional jig-based method . We r and omly allocated 71 patients to undergo either computer-navigated or conventional replacement .  An improved alignment was seen in the computer-navigated group . The patients were then followed up post-operatively for two years , using the Knee Society score , the Short Form-36 health survey , the Western Ontario and McMaster Universities osteoarthritis index , the Bartlett Patellar pain question naire and the Oxford knee score , to assess functional outcome . At two years post-operatively 60 patients were available for assessment , 30 in each group and 62 patients completed a postal survey . No patient in either group had undergone revision . All variables were analysed for differences between the groups either by Student 's t-test or the Mann-Whitney U test . Differences between the two groups did not reach significance for any of the outcome measures at any time point . At two years postoperatively , the frequency of mild to severe anterior pain was not significantly different ( p = 0.818 ) , varying between 44 % ( 14 ) for the computer-navigated group , and 47 % ( 14 ) for the conventionally-replaced group . The Bartlett Patellar score and the Oxford knee score were also not significantly different ( t-test p = 0.161 and p = 0.607 , respectively ) . The clinical outcome of the patients with a computer-navigated knee replacement appears to be no different to that of a more conventional jig-based technique at two years post-operatively , despite the better alignment achieved with computer-navigated surgery
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 .