Precision over pace: A comparative study of VELYS robotic-assisted versus conventional primary total knee arthroplasty: A prospective randomized study.

BACKGROUND

Total knee arthroplasty (TKA) is a well-established procedure for end-stage knee osteoarthritis. Robotic-assisted TKA aims to improve precision and reduce complications compared to conventional methods. This simple randomized study involved a comparison of robotic-assisted TKA with the VELYS robotic system to conventional TKA on accuracy of alignment, blood loss, and surgical duration.

METHODS

A prospective simple randomized study was conducted involving 200 patients who underwent either robotic-assisted or conventional TKA, with all participants followed for at least six months. Radiographic evaluation comprised assessment of the Hip-Knee-Ankle (HKA) axis deviation, Lateral Distal Femoral Angle (LDFA), Medial Proximal Tibial Angle (MPTA), and posterior tibial slope. In addition, intraoperative variables-including estimated blood loss and operative duration-were documented and compared between the two groups.

RESULTS

Robotic-assisted TKA demonstrated superior alignment accuracy, with a statistically significant but smaller mean HKA axis deviation compared to conventional TKA (0.09° ± 0.2 vs 0.32° ± 0.66; p = 0.001). Intraoperative blood loss was also notably lower in the robotic group (124.58 ± 57.73 mL vs 201.74 ± 81.11 mL; p < 0.001). Conversely, procedures performed with robotic assistance required more operative time, with a higher mean duration than conventional surgery (89.8 ± 13.4 min vs 62.8 ± 11.3 min; p < 0.001).

CONCLUSION

Robotic-assisted TKA performed with the VELYS platform demonstrated enhanced accuracy in component alignment and was associated with lower intraoperative blood loss, though at the expense of longer operative time. These results suggest that robotic technology may improve surgical precision in TKA; however, extended follow-up is required to determine its long-term cost-effectiveness, impact on implant longevity and overall outcome and patient satisfaction.