Evidence map›Paper›PMID 40713594›Full record

ArticleJournal of orthopaedic surgery and research2025

Comparative analysis of femoral component rotational accuracy in robotic-assisted versus navigation-assisted total knee arthroplasty.

Azlina Amir Abbas, Kwong Weng Loh, Santhi Varatharaja Pillai, Mohd Amin Sulaiman, Chong Meng Lee

Abstract readComparative Study
In one paragraph

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 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Azlina Amir Abbas *National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia. azabbas@um.edu.my.
Kwong Weng Loh *National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia. melvinloh@um.edu.my.
Santhi Varatharaja PillaiSubang Jaya Medical Centre, No.1 Jalan SS12/1A, Subang Jaya, Selangor, 47500, Malaysia.
Mohd Amin SulaimanSubang Jaya Medical Centre, No.1 Jalan SS12/1A, Subang Jaya, Selangor, 47500, Malaysia.
Chong Meng LeeSubang Jaya Medical Centre, No.1 Jalan SS12/1A, Subang Jaya, Selangor, 47500, Malaysia. chongmenglee@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMisalignment and improper implant positioning in total knee arthroplasty (TKA) are key predictors of early prosthesis loosening and failure. Correct femoral component rotation is essential for proper patellar tracking, balanced flexion gap, and correct limb alignment during flexion. The objective of this study is to assess and compare the precision of femoral component rotational placement between robotic-assisted TKA (RA-TKA) and navigation-assisted TKA (NA-TKA) surgeries.

methodsThis single-surgeon retrospective case-control study involved 60 knees from 37 patients, with 30 knees in the robotic-assisted group and 30 knees in the navigation-assisted group. The procedures utilized either a semi-active robotic system (MAKO) or an image-free eNlite navigation system. Femoral component rotational placement and limb alignment were assessed using computed tomography scans and full-length standing anterior-posterior radiographs.

resultsThe NA-TKA group had a higher proportion of female patients (80%) and was younger on average (64.9 ± 18.4 years), while the RA-TKA group had 65% female patients with an average age of 68.4 ± 8.1 years. There were no significant differences in the absolute errors between intraoperative plans and postoperative alignment of the femoral component in the axial plane between RA-TKA (0.9°±1.9°) and NA-TKA (0.6°±1.6°). Postoperative hip-knee-ankle angles were similarly restored in both groups (RA-TKA: 0.2°±2.6°, NA-TKA: 0.9°±1.7°; p = 0.22). The NA-TKA group had fewer outliers (> 3°) for femoral component rotational placement (p = 0.45).

conclusionOur study indicates that RA-TKA achieves similar accuracy in femoral component rotational placement compared to NA-TKA. While RA-TKA aims for the highest accuracy in femoral component placement, it may not necessarily surpass the accuracy of navigation-assisted techniques. LEVEL OF EVIDENCE: Level III.

Indexed as

Arthroplasty, Replacement, KneeFemurRobotic Surgical ProceduresSurgery, Computer-AssistedSurgical Navigation SystemsAgedAged, 80 and overCase-Control StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesRotationFemoral componentNavigation-assisted total knee arthroplastyRobotic surgeryRotational alignment accuracy

Identifiers

PMID40713594
PMCPMC12297850

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.