ArticleJournal of robotic surgery2026
Magnitude of intraoperative femoral rotational adjustment from the initial plan is associated with slower early recovery after robotic-assisted functional-alignment TKA.
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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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.
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6 authors.
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Abstract
Currently, safe-zone research in robotic-assisted total knee arthroplasty (TKA) has focused mainly on the final implant position, whereas whether intraoperative adjustment of implant position relative to the initial plan affects early functional recovery remains unclear. This retrospective cohort study evaluated the relationship of the magnitude and direction of intraoperative implant adjustment with early functional recovery in functionally aligned robotic-assisted TKA. We analyzed 210 primary TKA knees with complete intraoperative implant parameters and follow-up data. Relative adjustment was defined as the executed minus planned value, with its absolute value (|Δ|) representing the adjustment magnitude. Multivariable linear regression assessed the relationship between adjustment magnitude across five dimensions and improvement from baseline in the Knee Society Score (KSS) and Forgotten Joint Score-12 (FJS-12) at 1, 3, 6, and 12 months. Among the five dimensions assessed in these 210 knees, only femoral rotational adjustment magnitude was consistently associated with poorer early recovery: for each 1° increase in |Δ|, FJS-12 improvement decreased by 3.27, 3.82, and 4.58 points at 1, 3, and 6 months (all P < 0.001), whereas at 12 months the association was no longer statistically significant (β = -1.22; P = 0.071). Compared with unadjusted knees, those undergoing femoral rotational adjustment showed reductions of approximately 5.9-6.2 points in KSS and 10.4-10.9 points in FJS-12 improvement over the first 6 months, whereas adjustment direction showed no significant association with outcomes. Larger femoral rotational adjustment was associated with delayed early functional recovery and may be an intraoperative marker of a difficult-to-balance flexion gap, suggesting that when large rotational adjustment is required, flexion-gap balance and the patellofemoral relationship should be reassessed.
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