Aflatooni Justin O, Wininger Austin E, Sullivan Thomas C, Brown Timothy S, Park Kwan J
Houston Methodist Orthopedics & Sports Medicine, Houston, TX, USA.
Arthroplast Today. 2025 Jul 19;34:101774. doi: 10.1016/j.artd.2025.101774. eCollection 2025 Aug.
Robotic-assisted total knee arthroplasty (rTKA) is utilized to facilitate accurate and precise resection goals. Most literature has focused on postoperative limb and component alignment in the coronal plane. This study sought to evaluate the accuracy of 2 robotic systems in executing sagittal plane resections during rTKA.
This retrospective review analyzed 169 consecutive primary rTKAs at a single institution from January 2023 to January 2024. Surgeries were performed by two fellowship-trained arthroplasty surgeons, each using a different rTKA system (73 System 1 and 96 System 2). Femoral and tibial component sagittal alignment were measured on postoperative and compared to intraoperative plans.
Both systems more frequently resulted in reduced tibial slope than planned slope (75.3% System 1, 84.4% System 2). The average absolute difference between planned and measured tibial slope was 1.4 ± 1.0° ( = .01) for System 1 and 2.4 ± 1.5° ( < .001) for System 2 with 93.9% and 66.7% having a difference of <3°, respectively. For femoral component sagittal alignment, both systems resulted in roughly an even split of cases with increased and decreased femoral flexion. The average absolute difference between planned and measured femoral flexion was 1.5 ± 1.1° ( = .23) for System 1 and 1.8 ± 1.5° ( = .28) for System 2 with 90.4% and 86.5% having a difference of <3°, respectively.
These findings better elucidate discrepancies between planned and executed tibial and femoral sagittal component alignment of 2 popular robotic systems, which may play an important role as TKA limb alignment and component positioning goals become more individualized.
机器人辅助全膝关节置换术（rTKA）用于实现精确的截骨目标。大多数文献关注的是冠状面术后肢体和假体的对线情况。本研究旨在评估两种机器人系统在rTKA矢状面截骨操作中的准确性。
本回顾性研究分析了2023年1月至2024年1月在一家机构连续进行的169例初次rTKA手术。手术由两位接受过专科培训的关节置换外科医生进行，每人使用不同的rTKA系统（73例使用系统1，96例使用系统2）。在术后测量股骨和胫骨假体的矢状面对线情况，并与术中计划进行比较。
两个系统导致胫骨斜率低于计划斜率的情况更为常见（系统1为75.3%，系统2为84.4%）。系统1计划和测量的胫骨斜率平均绝对差值为1.4±1.0°（P =.01），系统2为2.4±1.5°（P <.001），分别有93.9%和66.7%的差值<3°。对于股骨假体矢状面对线，两个系统导致股骨屈曲增加和减少的病例大致平分。系统1计划和测量的股骨屈曲平均绝对差值为1.5±1.1°（P =.23），系统2为1.8±1.5°（P =.28），分别有90.4%和86.5%的差值<3°。
这些发现更好地阐明了两种常用机器人系统计划和执行的胫骨和股骨矢状面假体对线之间的差异，随着TKA肢体对线和假体定位目标变得更加个体化，这些差异可能发挥重要作用。
