ArticleJournal of orthopaedic surgery and research2025
Robot-assisted total knee arthroplasty is more precise than conventional total knee arthroplasty in restoring knee, but not ankle alignment: a retrospective study based on imaging data.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Iatrogenic coronal-sagittal coupling driven by a 12.4° rotational mismatch in manual total knee arthroplasty and precise decoupling with robotic assistance: a radiographic retrospective cohort study.Arthroplasty (London, England) · 2026Article
- Robotic vs. conventional total knee arthroplasty over two decades: Evolving trends toward personalised alignment without significant clinical superiority in predominantly mild varus deformity-A systematic review of RCTs.Journal of experimental orthopaedics · 2025Review
- Digitized Precision Corrective Osteotomy for Treating Knee Joint Deformities: Current Evidence and Future Perspectives.Orthopaedic surgery · 2025Review
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Authors and funding
5 authors.
Funding
Abstract
backgroundKnee osteoarthritis often leads to varus deformity, disrupting lower limb alignment and potentially causing ankle osteoarthritis. While total knee arthroplasty (TKA) can correct knee alignment and improve ankle alignment, the impact of different alignment strategies on the ankle remains unclear. This study investigates whether robot-assisted functional alignment (RA-FA) offers advantages over conventional mechanical alignment (CM-MA) in correcting ankle alignment, addressing the paucity of evidence on the impact of alignment strategies on distal joint biomechanics.
methodsA retrospective analysis was conducted on radiographic data from 202 patients with primary knee osteoarthritis who underwent TKA. Patients were divided into two groups based on the surgical approach: CM-MA group and RA-FA group, with 101 patients in each group. Using preoperative and postoperative full-length lower limb X-rays, multiple coronal radiographic parameters of the knee and ankle joints were measured. The correlation between knee and ankle alignments was assessed. Patients were further subgrouped based on the type of knee varus deformity, and differences in alignment correction between CM-MA and RA-FA within these subgroups were analyzed.
resultsPreoperatively, there were no significant differences in radiographic parameters of the knee and ankle between the two groups. Postoperatively, the RA-FA group showed superior correction in HKA and mLDFA compared to the CM-MA group. However, no statistically significant differences were observed between the two groups regarding ankle alignment correction. Subgroup analysis revealed that RA-FA was more effective in correcting knee alignment in specific subgroups. Nevertheless, even in these subgroups, RA-FA did not demonstrate a significant advantage over CM-MA in correcting ankle alignment.
conclusionThis study highlights the close relationship between knee and ankle alignments and confirms that TKA can improve ankle alignment. While RA-FA allows for more precise adjustments in femoral osteotomy and implant positioning, it does not significantly improve ankle alignment compared to CM-MA. Future studies should investigate the long-term effects of TKA on ankle alignment and evaluate whether other alignment strategies or different types of prostheses may influence the prognosis of the ankle or more distal joints such as the subtalar joint.
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