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Background: Robotic-assisted total knee arthroplasty (RA-TKA) was introduced to provide surgeons with virtual preoperative planning and intraoperative information to achieve the desired surgical goals in an effort to improve patient outcomes. The purpose of this study was to compare clinical outcomes and patient-reported outcome measures following primary TKA using RA-TKA vs manual instrumentation.
Methods: This was a retrospective cohort review study comparing 393 primary RA-TKAs vs 312 manual TKAs at a minimum 2-year follow-up. The same cementless implant design was utilized in all cases at a single institution. There were no significant differences in age or gender between groups. Outcome measures included range-of-motion, Knee Society (KSS), Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score-12, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and overall patient satisfaction scores along with complications and survivorship.
Results: Compared to manual TKA, the RA-TKA group had significant higher postoperative KSS Function and Knee scores, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores ( < .001). A total percentage of 95.0% of RA-TKA vs 87.4% of manual TKAs were very satisfied or satisfied ( = .001). Survivorship with all-cause failure as the endpoint at 3 years was 96.9% in the RA-TKA group compared to 95.8% in the manual group ( = .54).
Conclusions: RA-TKA demonstrated significant improvement over manual jig-based instruments in KSS Function, KSS Knee, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and patient satisfaction scores following primary TKA with no differences in complications and revision incidence. RA-TKA provided a virtual 3-dimensional preoperative plan along with intraoperative information for adjustments to approximate the patients' native joint line and achieve a well-balanced soft-tissue sleeve about the knee for primary TKA.
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http://dx.doi.org/10.1016/j.artd.2024.101488 | DOI Listing |
Clin Orthop Relat Res
August 2025
Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA.
Background: Choosing the appropriate implants for reconstruction in revision TKA is essential for long-term fixation. While cones and augments are routinely utilized to address tibial defects, the effect of augment location and size on the biomechanical stability of revision TKA constructs and the indications for the use of metaphyseal cones are not known.
Questions/purposes: Is the risk of cement-implant debonding of revision TKA constructs impacted by the thickness and location (medial versus bicompartmental) of tibial augments and the presence of metaphyseal cones during (1) a demanding daily activity like stair ascent and (2) torsional loads?
Methods: Under institutional review board approval, we developed patient-specific finite-element models of revision TKA from four patients (three males and one female, ages 50 to 80 years, BMI 27 to 37 kg/m2) who underwent two-stage revision and had a CT scan with no metal artifact after first-stage implant removal.
BMJ Open
September 2025
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Introduction: The management of bleeding and coagulation after total knee arthroplasty (TKA) has long been recognised as a significant challenge for orthopaedic surgeons. Despite the notable success of empirical anticoagulation in preventing venous thromboembolism (VTE) following TKA, the increased risk of postoperative bleeding has also raised extensive concern. Ecchymosis, as one of the most common manifestations indicating postoperative bleeding, holds the potential to indicate the balance of bleeding and hypercoagulation.
View Article and Find Full Text PDFAnesth Analg
September 2025
From the Department of Anesthesiology.
Background: Total knee arthroplasty (TKA) is a surgical procedure that induces intense acute postoperative pain, but the mechanisms that amplify post-TKA pain remain incompletely understood. Endocannabinoids, such as 2-arachidonoylglycerol (2-AG), are endogenous lipids that can produce antinociceptive effects. However, hydrolysis of 2-AG by monoacylglycerol lipase (MAGL) generates arachidonic acid, the precursor to a host of eicosanoids that enhance pain.
View Article and Find Full Text PDFJ Orthop Res
September 2025
University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
The primary purpose of this study was to determine the preoperative predictors of gait biomechanics 6 months after unilateral total knee arthroplasty (TKA). There were 126 participants (age 64.4 ± 7.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2025
Department of Orthopedic Surgery, Martini Hospital Groningen, Groningen, the Netherlands.
Purpose: Total knee arthroplasty (TKA) following an osteotomy around the knee might be technically more challenging and yield inferior outcome compared with primary TKA. The aim of this study was to investigate the survival, use of revision components and clinical outcome of TKAs postosteotomy compared with primary TKAs.
Methods: Patients from the Dutch Arthroplasty Register who underwent TKA after osteotomy or primary TKA with osteoarthritis as primary diagnosis from 2007 to 2022 and aged ≥18 years at the time of the procedure were selected.