ArticleArchives of orthopaedic and trauma surgery2021
Joint line is restored in robotic-arm-assisted total knee arthroplasty performed with a tibia-based functional alignment.
Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 44 citations in OpenAlex.
- Comparable clinical outcomes in functionally aligned computer-assisted and image-based robotic assisted total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Observational
- Comparison of Mid-Term Clinical and Radiologic Outcomes Between Measured Resection Technique and Gap Balanced Technique After Total Knee Arthroplasty Using Medial Stabilizing Technique for Severe Varus Knee: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2025Article
- Femoral component rotational alignment in robotic-assisted total knee arthroplasty with functional knee positioning varies across knee phenotypes without affecting clinical outcomes.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Observational
- Joint line elevation after TKA is higher in patients with metaphyseal deformity: a prospective study.Archives of orthopaedic and trauma surgery · 2025Article
- Accuracy and learning curve of imageless robotic-assisted total knee arthroplasty.Journal of orthopaedics · 2025Article
- Comparison of Outcomes Between Functionally and Mechanically Aligned Total Knee Arthroplasty: Analysis of Parallelism to the Ground and Weight-Bearing Position of the Knee Using Hip-to-Calcaneus Radiographs.Journal of personalized medicine · 2025Article
- The utility of robotic-assisted surgery in total knee arthroplasty for moderate and severe valgus deformities: a case series.Journal of orthopaedic surgery and research · 2025Article
- The Role of Computed Tomography in Achieving True External Rotation in Robotic Knee Replacement: A Retrospective Analysis of 300 Knees.Journal of orthopaedic case reports · 2025Article
- Comparison of the efficacy and safety of MAKO robot-assisted total knee arthroplasty versus conventional manual total knee arthroplasty in uncomplicated unilateral total knee arthroplasty a single-centre retrospective analysis.International orthopaedics · 2024Article
- High return to sport rate in patients undergoing image-based robotic arm assisted unicompartmental knee arthroplasty.Archives of orthopaedic and trauma surgery · 2024Article
- Radiologic Assessment of Knee Phenotypes Based on the Coronal Plane Alignment of the Knee Classification in a Korean Population.Clinics in orthopedic surgery · 2024Article
- Current concept: personalized alignment total knee arthroplasty as a contrast to classical mechanical alignment total knee arthroplasty.Arthroplasty (London, England) · 2024Article
- Joint line position change in primary total knee arthroplasty: a radiographic analysis comparing conventional and robotic techniques.International orthopaedics · 2024Article
- The Effect of Severe Varus Deformity on Clinical and Radiographic Outcomes in Mechanical Aligned Total Knee Arthroplasty with Medial Stabilizing Technique.Journal of clinical medicine · 2024Article
- A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties.Arthroplasty today · 2024Article
- Methods of alignment in total knee arthroplasty, systematic review.Orthopedic reviews · 2024Article
- Robotic-arm assisted total knee arthroplasty is associated with comparable functional outcomes but improved forgotten joint scores compared with conventional manual total knee arthroplasty at five-year follow-up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Virtual assessment of coronal balance prior to bone resection with the MAKO robotic-assisted system accurately predicts final balance in TKA.Journal of robotic surgery · 2023Article
- Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Functional alignment with robotic‑arm assisted total knee arthroplasty demonstrated better patient-reported outcomes than mechanical alignment with manual total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFunctional alignment (FA) in total knee arthroplasty (TKA) has been introduced to restore the native joint line obliquity, respect the joint line height and minimize the need of soft tissue releases. The purpose of this study was to assess the intraoperative joint line alignment and compare it with the preoperative epiphyseal orientation of the femur and tibia in patients undergoing robotic-arm-assisted (RA)-TKA using FA. MATERIALS AND
methodsThis retrospective study included a consecutive series of patients undergoing RA-TKA between February 2019 and February 2021. The joint line orientation of the femur and tibia in the three-dimensions was calculated and classified on preoperative CT-scans and compared with the intraoperative implant alignment. The tibial cut was performed according to the tibial preoperative anatomy. The femoral cuts were fine-tuned based on tensioned soft tissues, aiming for balanced medial and lateral gaps in flexion and extension.
resultsA total of 115 RA-TKAs were assessed. On average, the tibial component was placed at 1.8° varus (SD 1.3), while the femur was placed at 0.8° valgus (SD 2.2) and 0.6° external rotation (SD 2.6) relative to the surgical transepicondylar axis. Moderate to strong, statistically significant relationships were described between preoperative tibial coronal alignment and tibial cut orientation (r = 0.7, p < 0.0001), preoperative femoral orientation in the coronal and axial planes and intraoperative femoral cuts alignment (r = 0.7, p < 0.0001 and r = 0.5, p < 0.0001, respectively). One case (0.9%) of slight tibial component varus subsidence was reported 45-days post-operatively, but implant revision was not necessary.
conclusionsThe proposed robotic-assisted functional technique for TKA alignment, with a restricted tibial component coronal alignment, based on the preoperative phenotype and femoral component positioning as dictated by the soft tissues, provided joint line respecting resections. Further studies are needed to assess long-term implant survivorship, patient satisfaction and alignment-related failures.
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