Evidence map›Paper›PMID 41091159›Full record

SynthesisInternational orthopaedics2025

Robotic-Assisted unicompartmental knee arthroplasty restores native joint line height and reduces alignment outliers.

George Mihai Avram, Horia Tomescu, Randa Elsheikh, Giacomo Pacchiarotti, Octav Russu, Vlad Rusu, Dennis Cicio, Andrej M Nowakowski, Michael Tobias Hirschmann, Vlad Predescu

Abstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–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

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Accuracy of ROSAJournal of clinical medicine · 2026
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

George Mihai AvramResearch Group Michael T. Hirschmann, Department of Clinical Research, Faculty of Medicine, University of Basel, Basel, Switzerland. george.mihai.avram@gmail.com.
Horia TomescuFaculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Randa ElsheikhResearch Group Michael T. Hirschmann, Department of Clinical Research, Faculty of Medicine, University of Basel, Basel, Switzerland.
Giacomo PacchiarottiDepartment of Anatomy, Histology, Legal Medicine, and Orthopaedics, Sapienza University of Rome, Roma, Italy.
Octav RussuOrthopaedic and Traumatology Department, Pharmacy, Sciences and Technology George Emil Palade, University of Medicine, Targu Mures, Romania.
Vlad RusuFaculty of General Medicine, University of Medicine, Pharmacy, Sciences and Technology "George Emil Palade" of Târgu Mureş, Targu Mures, Romania.
Dennis CicioFaculty of General Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Andrej M NowakowskiUniversity Clinic for Orthopaedics & Traumatology, Kantonsspital Baselland Bruderholz, Bruderholz, Switzerland.
Michael Tobias HirschmannUniversity Clinic for Orthopaedics & Traumatology, Kantonsspital Baselland Bruderholz, Bruderholz, Switzerland.
Vlad PredescuOrthopaedics and Traumatology Department, Ponderas Academic Hospital, Bucharest, Romania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRegistry data suggests that robotic-assisted unicompartmental knee arthroplasty (rUKA) significantly reduces all-cause revisions compared to conventional implantation (cUKA). This study aims to compare joint line-related parameters and their reconstruction accuracy between rUKA and cUKA.

methodsFive databases were searched using a pre-defined strategy and inclusion criteria: (1) comparative studies reporting radiological outcomes, (2) human studies, (3) English language, and (4) meta-analyses for cross-referencing. Cadaveric or saw-bone studies were excluded. Data extracted included demographics data, pre- and postoperative radiological parameters (HKA, MPTA, LDFA, posterior tibial slope, femoral sagittal angle, joint line height, implant congruency), and outliers. A random-effects meta-analysis was conducted using mean difference (MD) and odds ratio (OR) as main effect estimators. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), and publication bias was evaluated with funnel plots.

resultsA total of 18 studies assessing 2470 patients (1112 rUKA, 1358 cUKA) were included in the analysis. No significant baseline differences were found in age, sex, BMI, follow-up period, MPTA, LDFA, or tibial slope. Postoperative radiological parameters showed no significant differences between groups for HKA, LDFA, MPTA, or tibial slope (p > 0.05). Joint line height was significantly lower in cUKA compared to rUKA (MD = -1.37 mm, 95% CI: -2.06 to -0.69, p < 0.001). Outlier analysis revealed that rUKA had significantly fewer outliers across relevant radiological parameters, including HKA, joint line height, tibial slope, femoral flexion, femoral implant congruency, and medial, anterior, and posterior tibial congruency.

conclusionReporting pre- and postoperative mean alignment parameters undermines patient-specific anatomy reconstruction with advanced technologies. Outlier reporting showed significant variability, with limited evidence supporting its clinical relevance. Future studies should focus on patient-specific reconstruction and define clinical thresholds for outliers.

Indexed as

Arthroplasty, Replacement, KneeBone MalalignmentKnee JointOsteoarthritis, KneeRobotic Surgical ProceduresAgedFemaleHumansMaleRadiographyReoperationTibiaTreatment OutcomeConventional UKAJoint lineRobotic UKA

Identifiers

PMID41091159
PMCPMC12594688

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.