Perioperative safety and accuracy of CT-based fully active burr-based robotic total knee arthroplasty: a retrospective study.

BACKGROUND

Robotic-assisted total knee arthroplasty (RA-TKA) aims to improve surgical precision with maximum patient safety. This study evaluates the safety and accuracy of the fully active robotic system.

METHODS

A retrospective observational study of 315 consecutive RA-TKAs was conducted over a period of 15 months. Primary outcomes included safety (neurovascular injury, ligamentous injury, pin-site complications) and accuracy (concordance between preoperative 3D CT planning and fi nal implant size & targeted polyethylene size).

RESULTS

The robotic procedure was successfully completed in 315cases, and 3 cases were abandoned (n=318). Tibial component size concordance was 100%, while femoral concordance was 98.7%. Target polyethylene thickness (9-11mm) was achieved in 97.8% of cases. Safety outcomes showed zero neurovascular or MCL injuries. Iatrogenic PCL injury occurred in one case (0.32%) following a system interruption. Pin-site discharge(1.6%) was observed exclusively in the fi rst 104 cases, and no cases were reported after transitioning to intra-incisional pin placement. No cases of femoral or tibial overhang were recorded.

CONCLUSION

The CT-based fully active robotic system provides predictable intraoperative accuracy in implant and polyethylene sizing while maintaining a high safety profi le. Refi ning surgical techniques, such as intra-incisional pin placement, signifi cantly reduces minor perioperative morbidity.