Evidence map›Paper›PMID 41656478›Full record

ArticleJournal of robotic surgery2026

Robot-assisted total knee arthroplasty: a limited learning curve for ligament balancing.

Fanny Delaigue, Pascal Bizot, Jules Descamps, Flore Devriese, Axelle Portet, Rémy Nizard, Pierre-Alban Bouché

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Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Fanny DelaigueOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France. fanny.delaigue@aphp.fr.
Pascal BizotOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
Jules DescampsOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
Flore DevrieseOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
Axelle PortetOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
Rémy NizardOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
Pierre-Alban BouchéOrthopedic and Traumatology Surgery Department, Lariboisière Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Robotic-assisted total knee arthroplasty (RA-TKA) aims to improve implant positioning and soft tissue balance, but few studies have evaluated the learning curve (LC) for intraoperative ligament balancing.

methodsWe retrospectively analyzed 234 posterior-stabilized RA-TKAs performed by three surgeons with varying prior experience using the MAKO system. The primary endpoint was the learning curve duration for mastering ligament balancing, classified as perfectly balanced, stable, or unstable based on medial and lateral joint line openings in extension and flexion. Learning curves for ligament balancing and operative time were assessed using LC-CUSUM analysis.

resultsOverall, 79.8% of TKAs were perfectly balanced, 19.1% stable, and 1.1% unstable. The LC for overall ligament balancing ranged from 5 to 9 cases depending on the surgeon. Operative time normalized after 12 to 22 cases, shorter for surgeons with prior navigation experience. Complications were minimal, with no early infections and few mechanical issues.

conclusionsOptimal ligament balancing with RA-TKA is achieved rapidly and remains stable, with operative times comparable to conventional techniques after the LC. Prior experience with navigation-assisted surgery shortens the LC. These findings support the reproducibility and safety of robotic ligament balancing, though further studies are needed to confirm long-term clinical benefits.

Indexed as

Arthroplasty, Replacement, KneeLearning CurveLigamentsLigaments, ArticularRobotic Surgical ProceduresAgedFemaleHumansMaleMiddle AgedOperative TimeRetrospective StudiesLearning curveLigament balancingRobotic-assisted arthroplastyTotal knee arthroplasty

Identifiers

PMID41656478

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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.