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Comparison of imageless robotic assisted total knee arthroplasty and conventional total knee arthroplasty: early clinical and radiological outcomes of 200 knees

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Abstract

The aim of this study was to compare the short term clinical and radiological outcomes of imageless robotic and conventional total knee arthroplasty (TKA) and to estimate the accuracy of the two techniques by analysing the outliers after TKA. We have evaluated 200 consecutive knees (158 patients), 100 knees undergoing robotic TKA, and 100 knees treated with conventional TKA. Demographic parameters like age, gender, body mass index, diagnosis and range of motion were obtained. Knee society score (KSS) and Knee society functional score (KSS-F) were used for clinical evaluation. Mechanical alignment (Hip-knee-ankle angle), proximal tibial angle (MPTA), distal femoral angle (LDFA) and tibial slope were analysed for radiological results and outliers were compared between both groups. Outliers were defined when the measured angle exceeded ± 3° from the neutral alignment in each radiological measurement on the final follow-up radiograph.The minimum follow-up was 6 months (range, 6 to 18 months). The preoperative mean HKA angle was 169.7 ± 11.3° in robotic group and 169.3 ± 7.3° in conventional group. There was significant improvement in HKA, LDFA, MPTA and tibial slope compared to the preoperative values in both the groups (p < 0.01). The number of HKA, LDFA and tibial slope outliers were 31, 29 and 37, respectively, in the conventional group compared to 13, 23 and 17 in the robotic group (p < 0.01). There was a significant improvement in the KSS and KSS-F functional scores postoperatively in both the groups (p < 0.01). However, there was no significant difference in the functional scores between the groups postoperatively (p = 0.08). This study showed excellent improvement with both imageless robotic and conventional TKA, with similar clinical outcomes between both groups. However, radiologically robotic TKA showed better accuracy and consistency with fewer outliers compared with conventional TKA.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, Ganga Hospital, 313, Mettupalayam Road, Coimbatore, 641 043, India

    Shanmuganathan Rajasekaran, Dhanasekaran Soundarrajan, Rithika Singh, Bahru Atnafu Shiferaw, Raja Bhaskara Rajasekaran, Palanisami Dhanasekararaja & Natesan Rajkumar

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  1. Shanmuganathan Rajasekaran
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  2. Dhanasekaran Soundarrajan
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  3. Rithika Singh
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  4. Bahru Atnafu Shiferaw
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  6. Palanisami Dhanasekararaja
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  7. Natesan Rajkumar
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Soundarrajan Dhanasekaran, Bahru Atnafu Shiferaw and Rithika Singh. The first draft of the manuscript was written by Shanmuganathan Rajasekaran, Soundarrajan Dhanasekaran and Rithika Singh. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Shanmuganathan Rajasekaran.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Ethics Committee (IRB Approval No: 7/11/2022).

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Rajasekaran, S., Soundarrajan, D., Singh, R. et al. Comparison of imageless robotic assisted total knee arthroplasty and conventional total knee arthroplasty: early clinical and radiological outcomes of 200 knees. J Robotic Surg 18, 151 (2024). https://doi.org/10.1007/s11701-024-01905-x

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