Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation

Abstract Background This study compared imageless robotic-assisted total knee arthroplasty (RATKA) with accelerometer-based navigation (ABN) systems in terms of surgical accuracy and early clinical outcomes. Methods A retrospective analysis was conducted on 153 patients (178 knees) who had undergone...

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Main Authors: Joshua Yeuk-Shun Tran, Abbie Yan-Tung Tang, Cham-Kit Wong, Gloria Yan-Ting Lam, Tsz-Lung Choi, Rex Wang-Fung Mak, Jonathan Patrick Ng, Kevin Ki-Wai Ho, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Arthroplasty
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Online Access:https://doi.org/10.1186/s42836-025-00303-4
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author Joshua Yeuk-Shun Tran
Abbie Yan-Tung Tang
Cham-Kit Wong
Gloria Yan-Ting Lam
Tsz-Lung Choi
Rex Wang-Fung Mak
Jonathan Patrick Ng
Kevin Ki-Wai Ho
Michael Tim-Yun Ong
Patrick Shu-Hang Yung
author_facet Joshua Yeuk-Shun Tran
Abbie Yan-Tung Tang
Cham-Kit Wong
Gloria Yan-Ting Lam
Tsz-Lung Choi
Rex Wang-Fung Mak
Jonathan Patrick Ng
Kevin Ki-Wai Ho
Michael Tim-Yun Ong
Patrick Shu-Hang Yung
author_sort Joshua Yeuk-Shun Tran
collection DOAJ
description Abstract Background This study compared imageless robotic-assisted total knee arthroplasty (RATKA) with accelerometer-based navigation (ABN) systems in terms of surgical accuracy and early clinical outcomes. Methods A retrospective analysis was conducted on 153 patients (178 knees) who had undergone primary TKA from 2017 to 2023. Surgical accuracy and functional outcomes were assessed up to 12 months post-operation using the Chi-square test, Student’s t-test, and ANCOVA. Subgroup analyses based on patient demographics were also conducted. Results Among 153 patients, 101 underwent RATKA, and 52 received ABN. RATKA demonstrated superior alignment accuracy with a significantly lower deviation from the planned alignment (P < 0.05). Additionally, RATKA led to significantly better postoperative functional scores at 6 weeks (P = 0.001) and 3 months (P = 0.001), even after adjusting for preoperative functional differences. Conclusions RATKA offers enhanced precision and improves early recovery compared to ABN, supporting its potential as a preferred technology for TKA. Its ability to optimize kinematic alignment may contribute to superior patient outcomes. Compared to ABN, RATKA provides a unique advantage by achieving greater accuracy in planned alignment, which may translate into improved functional recovery. Further research with larger cohorts is recommended to confirm these findings.
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spelling doaj-art-3413cf41dd51478ea69e688d9aeb44f72025-08-20T03:08:02ZengBMCArthroplasty2524-79482025-04-01711710.1186/s42836-025-00303-4Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigationJoshua Yeuk-Shun Tran0Abbie Yan-Tung Tang1Cham-Kit Wong2Gloria Yan-Ting Lam3Tsz-Lung Choi4Rex Wang-Fung Mak5Jonathan Patrick Ng6Kevin Ki-Wai Ho7Michael Tim-Yun Ong8Patrick Shu-Hang Yung9Department of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole HospitalDepartment of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole HospitalDepartment of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole HospitalDepartment of Orthopaedics and Traumatology, Prince of Wales HospitalDepartment of Orthopaedics and Traumatology, Prince of Wales HospitalDepartment of Orthopaedics and Traumatology, Prince of Wales HospitalDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongDepartment of Orthopaedics and Traumatology, Chinese University of Hong KongAbstract Background This study compared imageless robotic-assisted total knee arthroplasty (RATKA) with accelerometer-based navigation (ABN) systems in terms of surgical accuracy and early clinical outcomes. Methods A retrospective analysis was conducted on 153 patients (178 knees) who had undergone primary TKA from 2017 to 2023. Surgical accuracy and functional outcomes were assessed up to 12 months post-operation using the Chi-square test, Student’s t-test, and ANCOVA. Subgroup analyses based on patient demographics were also conducted. Results Among 153 patients, 101 underwent RATKA, and 52 received ABN. RATKA demonstrated superior alignment accuracy with a significantly lower deviation from the planned alignment (P < 0.05). Additionally, RATKA led to significantly better postoperative functional scores at 6 weeks (P = 0.001) and 3 months (P = 0.001), even after adjusting for preoperative functional differences. Conclusions RATKA offers enhanced precision and improves early recovery compared to ABN, supporting its potential as a preferred technology for TKA. Its ability to optimize kinematic alignment may contribute to superior patient outcomes. Compared to ABN, RATKA provides a unique advantage by achieving greater accuracy in planned alignment, which may translate into improved functional recovery. Further research with larger cohorts is recommended to confirm these findings.https://doi.org/10.1186/s42836-025-00303-4Handheld robotic surgeryTotal knee arthroplastyImageless navigationSurgical accuracyEarly clinical outcomesRobotic-assisted surgery
spellingShingle Joshua Yeuk-Shun Tran
Abbie Yan-Tung Tang
Cham-Kit Wong
Gloria Yan-Ting Lam
Tsz-Lung Choi
Rex Wang-Fung Mak
Jonathan Patrick Ng
Kevin Ki-Wai Ho
Michael Tim-Yun Ong
Patrick Shu-Hang Yung
Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
Arthroplasty
Handheld robotic surgery
Total knee arthroplasty
Imageless navigation
Surgical accuracy
Early clinical outcomes
Robotic-assisted surgery
title Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
title_full Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
title_fullStr Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
title_full_unstemmed Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
title_short Handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
title_sort handheld imageless robotic total knee arthroplasty improves accuracy and early clinical outcomes when compared with navigation
topic Handheld robotic surgery
Total knee arthroplasty
Imageless navigation
Surgical accuracy
Early clinical outcomes
Robotic-assisted surgery
url https://doi.org/10.1186/s42836-025-00303-4
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