Functional alignment in robotic total knee arthroplasty provides favourable outcomes and minimal early revisions: A systematic review and meta-analysis.
Vasileios Giovanoulis, Angelo V Vasiliadis, Luca Andriollo et al.
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In 30 seconds
This Level III systematic review and meta-analysis assessed functional outcomes and early aseptic revision after robotic-assisted primary total knee arthroplasty using functional alignment. It included 20 studies comprising 5155 TKAs, with a weighted mean follow-up of 2.5 years; all procedures used an image-based robotic system. Patient-reported outcomes were consistently high, and mean flexion increased from 119.3° preoperatively to 123°–124.8° postoperatively. Across cohorts, 18 aseptic revisions were reported, corresponding to a pooled proportion of 0.35% (95% CI 0.23-0.55).
Key findings
- Across 20 studies and 5155 TKAs, the weighted mean follow-up was 2.5 years.
- Postoperative KSS Knee scores ranged from 92.4-94.5, KSS Function from 91.4-93.4, and FJS from 74.8-77.5.
- Mean flexion improved from 119.3° preoperatively to 123°-124.8° postoperatively.
- Eighteen aseptic revisions were reported; the pooled proportion was 0.35% (95% CI 0.23-0.55).
Why it matters
The review brings together short- to mid-term evidence on a personalised alignment approach used with robotic-assisted TKA. Its findings suggest favourable reported function and few early aseptic revisions in the included cohorts, while the heterogeneous evidence and limited follow-up leave longer-term safety uncertain. These results help frame the current evidence base without establishing comparative superiority.
What to keep in mind
Follow-up was short to mid-term (weighted mean 2.5 years), and the review notes heterogeneous evidence and uncertainty about long-term safety. All procedures used an image-based robotic system.