Trial reportJournal of robotic surgery2023
Functional alignment is associated with increased incidence of pre-balance, reduced soft-tissue release, and post-operative pain compared to mechanical alignment in patients undergoing simultaneous bilateral robotic-assisted TKA.
Trial report in Journal of robotic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 20 citations in OpenAlex.
- Can a Total Knee System Providing 1 mm Increment of Polyethylene Insert Thickness Offer a Clinical Benefit?Medicina (Kaunas, Lithuania) · 2024Trial
- Asia-Pacific expert consensus on robotic-assisted hip and knee arthroplasty.Arthroplasty (London, England) · 2026Review
- Inter- and Intra-Rater Reliability of Pre-Resection Ligament Tension Assessment Using a Digital Tensioner in Imageless Robotic-Assisted Total Knee Replacement.Orthopaedic surgery · 2026Article
- Impact of femoral component flexion on gap balancing in varus knees using robotic technology: a comparative study of single-radius and multi-radius designs.Journal of robotic surgery · 2025Observational
- Robotic-assisted total knee arthroplasty achieves superior early postoperative outcomes compared to conventional techniques in patients with severe varus.Journal of experimental orthopaedics · 2025Article
- Influence of Femoral Component Flexion on Outcomes After Primary Total Knee Arthroplasty.Arthroplasty today · 2025Article
- Comparative effects of mechanical and functional alignment in bilateral robotic total knee arthroplasty: a randomized controlled trial.Arthroplasty (London, England) · 2025Article
- Muscle Activation and Mobility After Robotic Total Knee Arthroplasty: Insights from Early Postoperative Recovery.Journal of clinical medicine · 2025Article
- Comparison between ligament balancing and measured resection in robot-assisted total knee arthroplasty: a 2-year follow up cohort study.BMC musculoskeletal disorders · 2025Article
- Trends in adoption of robotics in arthroplasty: an analysis of the Indian landscape.Journal of robotic surgery · 2025Observational
- Outcomes following functionally aligned total knee arthroplasty in severe varus deformity.Journal of clinical orthopaedics and trauma · 2025Article
- Article
- Comparison of the accuracy and efficacy of different assistive techniques in primary total knee arthroplasty: A network meta-analysis.Journal of experimental orthopaedics · 2024Article
- Preoperative evaluation of femoral and tibial sagittal alignment in robotic-assisted and conventional total knee arthroplasty and consequences for practice.International orthopaedics · 2024Article
- Operating room efficiency for a high-volume surgeon in simultaneous bilateral robotic-assisted total knee arthroplasty: a prospective cohort study.Journal of robotic surgery · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study aimed to compare two alignment strategies in the same patient undergoing simultaneous bilateral robotic-assisted TKA (SB-RATKA): mechanical alignment (MA), the gold-standard, and functional alignment (FA), a balance-driven, personalized alignment strategy. The outcome measures included quantitative assessment of soft-tissue release, incidence of knee balance, and post-operative pain. This was a prospective, self-controlled, randomized-controlled trial involving 72 patients who underwent SB-RATKA using the MAKO® robotic system with comparable grades of deformity and pain in both knees. 65 patients were finally included with one alignment strategy done per knee, with the patients blinded to the strategy used. The study recorded the additional soft-tissue releases required, incidence of pre-balance, and daily post-operative VAS pain scores. The mean age of the study population was 57.95 years, with a female preponderance (N = 53, 81.6%). MA group had significantly more medial compartment tightness in both flexion (MA-15.6 ± 1.8; FA-17 ± 1.3) and extension (MA-14.9 ± 1.9; FA-17 ± 1.1) (p < 0.0001) compared to the FA group after dynamic balancing. 66% of knees in the FA group (N = 43) achieved pre-balance compared to 32.3% in the MA group (N = 21) (p < 0.0001). VAS scores showed a significant reduction in pain in the FA group up to 72 h post-surgery (p < 0.0001). The requirement for posteromedial release (PM), posterior capsular (PC) release, tibial reduction osteotomy (TRO), and superficial MCL pie crusting (sMCL) were significantly lower in FA (PM-22, PC-13, TRO-8, sMCL-2) compared to MA (PM-44, PC-29, TRO-18, sMCL-8). Functional alignment strategy consistently resulted in a higher incidence of knee balance with a significant reduction in soft-tissue releases and immediate post-operative pain when compared to MA in the same patient undergoing SB-RATKA. Therapeutic Level 1.
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