# Comparable clinical outcomes in functionally aligned computer‐assisted and image‐based robotic assisted total knee arthroplasty

## TL;DR

This study found no significant differences in clinical outcomes between computer-assisted and robotic-assisted knee replacement surgeries after four years.

## Contribution

The study compares clinical outcomes of two surgical techniques for knee replacement using patient-specific alignment principles.

## Key findings

- No significant differences in clinical scores between computer-assisted and robotic-assisted TKA after four years.
- Both techniques showed excellent results with 100% survivorship and no revisions.
- Patient-specific functional alignment techniques yielded comparable outcomes in both groups.

## Abstract

To determine the clinical outcomes differences and complications in two comparable groups of patients undergoing computer aided surgery (CAS) and robotic‐assisted (RA) posterior stabilised (PS) total knee arthroplasty (TKA) following functional alignment (FA) principles with tibial pre‐cut at a minimum of 4‐year follow‐up.

This retrospective, monocentric and observational study included 94 consecutive patients undergoing PS TKA performed with CAS and RA‐TKA following FA principles, between January 2017 and January 2020. Patients were followed with radiological and clinical assessment and evaluated with the Forgotten Joint Score‐12 (FJS‐12), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS‐JR) and the 5‐Level Likert Scale (5‐LLS).

Out of 94 patients two were lost to follow‐up and one deceased in the robotic branch, eight patients were lost to follow‐up and two were deceased in the navigated branch. Hereby, a total of 84 patients (87 knees) with a mean age of 69.2 ± 8.4 years were considered. A total of 40 cases were included in the CAS group; 44 cases were included in the RA‐TKA group. No revisions were performed in any of the two groups, resulting in an overall Kaplan‐Meyer survivorship rate of 100% for both cohorts. At last follow‐up, no statistically significant differences were recorded between CAS and RA‐TKA relative to FJS‐12, KOOS‐JR and 5‐LLS (FJS‐12: 89.4 ± 9.5 vs. 88.3 ± 13.4; KOOS‐JR: 88.0 ± 10.2 vs 86.2 ± 11.5; 5‐LLS 4.4 ± 1.7 vs 4.6 ± 2.1) respectively.

No significant outcomes differences and complications were detected between patients undergoing PS‐TKA performed with either CAS and RA at a minimum 4‐year follow‐up. TKA performed with a patient‐specific FA technique and with a soft tissue‐preserving approach, showed excellent results with both CAS and RA‐TKA.

Level III.