Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty

Background: Robotic-assisted total knee arthroplasty (rTKA) is utilized to facilitate accurate and precise resection goals. Most literature has focused on postoperative limb and component alignment in the coronal plane. This study sought to evaluate the accuracy of 2 robotic systems in executing sag...

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Main Authors: Justin O. Aflatooni, MD, Austin E. Wininger, MD, Thomas C. Sullivan, BS, Timothy S. Brown, MD, Kwan J. Park, MD
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S235234412500161X
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author Justin O. Aflatooni, MD
Austin E. Wininger, MD
Thomas C. Sullivan, BS
Timothy S. Brown, MD
Kwan J. Park, MD
author_facet Justin O. Aflatooni, MD
Austin E. Wininger, MD
Thomas C. Sullivan, BS
Timothy S. Brown, MD
Kwan J. Park, MD
author_sort Justin O. Aflatooni, MD
collection DOAJ
description Background: Robotic-assisted total knee arthroplasty (rTKA) is utilized to facilitate accurate and precise resection goals. Most literature has focused on postoperative limb and component alignment in the coronal plane. This study sought to evaluate the accuracy of 2 robotic systems in executing sagittal plane resections during rTKA. Methods: This retrospective review analyzed 169 consecutive primary rTKAs at a single institution from January 2023 to January 2024. Surgeries were performed by two fellowship-trained arthroplasty surgeons, each using a different rTKA system (73 System 1 and 96 System 2). Femoral and tibial component sagittal alignment were measured on postoperative and compared to intraoperative plans. Results: Both systems more frequently resulted in reduced tibial slope than planned slope (75.3% System 1, 84.4% System 2). The average absolute difference between planned and measured tibial slope was 1.4 ± 1.0° (P = .01) for System 1 and 2.4 ± 1.5° (P < .001) for System 2 with 93.9% and 66.7% having a difference of <3°, respectively. For femoral component sagittal alignment, both systems resulted in roughly an even split of cases with increased and decreased femoral flexion. The average absolute difference between planned and measured femoral flexion was 1.5 ± 1.1° (P = .23) for System 1 and 1.8 ± 1.5° (P = .28) for System 2 with 90.4% and 86.5% having a difference of <3°, respectively. Conclusions: These findings better elucidate discrepancies between planned and executed tibial and femoral sagittal component alignment of 2 popular robotic systems, which may play an important role as TKA limb alignment and component positioning goals become more individualized.
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spelling doaj-art-53e68ce38a7a44f993a714e6573c47ad2025-08-20T03:51:14ZengElsevierArthroplasty Today2352-34412025-08-013410177410.1016/j.artd.2025.101774Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee ArthroplastyJustin O. Aflatooni, MD0Austin E. Wininger, MD1Thomas C. Sullivan, BS2Timothy S. Brown, MD3Kwan J. Park, MD4Houston Methodist Orthopedics &amp; Sports Medicine, Houston, TX, USAHouston Methodist Orthopedics &amp; Sports Medicine, Houston, TX, USAHouston Methodist Orthopedics &amp; Sports Medicine, Houston, TX, USAHouston Methodist Orthopedics &amp; Sports Medicine, Houston, TX, USACorresponding author. 6445 Main Street, Suite 2300, Houston, TX 77030, USA. Tel.: +1 832 212 6620.; Houston Methodist Orthopedics &amp; Sports Medicine, Houston, TX, USABackground: Robotic-assisted total knee arthroplasty (rTKA) is utilized to facilitate accurate and precise resection goals. Most literature has focused on postoperative limb and component alignment in the coronal plane. This study sought to evaluate the accuracy of 2 robotic systems in executing sagittal plane resections during rTKA. Methods: This retrospective review analyzed 169 consecutive primary rTKAs at a single institution from January 2023 to January 2024. Surgeries were performed by two fellowship-trained arthroplasty surgeons, each using a different rTKA system (73 System 1 and 96 System 2). Femoral and tibial component sagittal alignment were measured on postoperative and compared to intraoperative plans. Results: Both systems more frequently resulted in reduced tibial slope than planned slope (75.3% System 1, 84.4% System 2). The average absolute difference between planned and measured tibial slope was 1.4 ± 1.0° (P = .01) for System 1 and 2.4 ± 1.5° (P < .001) for System 2 with 93.9% and 66.7% having a difference of <3°, respectively. For femoral component sagittal alignment, both systems resulted in roughly an even split of cases with increased and decreased femoral flexion. The average absolute difference between planned and measured femoral flexion was 1.5 ± 1.1° (P = .23) for System 1 and 1.8 ± 1.5° (P = .28) for System 2 with 90.4% and 86.5% having a difference of <3°, respectively. Conclusions: These findings better elucidate discrepancies between planned and executed tibial and femoral sagittal component alignment of 2 popular robotic systems, which may play an important role as TKA limb alignment and component positioning goals become more individualized.http://www.sciencedirect.com/science/article/pii/S235234412500161XRobotic-assisted total knee arthroplastySagittal alignmentAccuracyROSAMAKO
spellingShingle Justin O. Aflatooni, MD
Austin E. Wininger, MD
Thomas C. Sullivan, BS
Timothy S. Brown, MD
Kwan J. Park, MD
Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
Arthroplasty Today
Robotic-assisted total knee arthroplasty
Sagittal alignment
Accuracy
ROSA
MAKO
title Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
title_full Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
title_fullStr Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
title_full_unstemmed Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
title_short Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty
title_sort accuracy of sagittal plane component alignment in robotic assisted total knee arthroplasty
topic Robotic-assisted total knee arthroplasty
Sagittal alignment
Accuracy
ROSA
MAKO
url http://www.sciencedirect.com/science/article/pii/S235234412500161X
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