Predictive Accuracy Analysis of a Novel Robotic-Assisted System for Total Knee Arthroplasty:A Prospective Observational Study

Haichuan Miao,1,2 Zhiyong Zhu,2 Huisheng Wang,2 Xizhuang Bai,2 Xi Li2 1Dalian Medical University, Dalian, 116044, People’s Republic of China; 2Department of Sports Medicine and Joint Surgery, The People’s Hospital of Liaoning Province, The People’s Hospital of China Medical University, Shenyang, 110000, People’s Republic of ChinaCorrespondence: Xizhuang Bai; Xi Li, Department of Sports Medicine and Joint Surgery, The People’s Hospital of Liaoning Province, The People’s Hospital of China Medical University, 33 Wenyi Road, Shenhe District, Shenyang, 110000, People’s Republic of China, Email educmu0922@163.com; lixiseki@gmail.comBackground: Robotic-assisted total knee arthroplasty (RATKA) has been reported to enhance operative decision-making. The purpose of this study was intended to assess the predictive accuracy of bone cuts, lower limb alignment, and component size of a novel system for RATKA preoperatively and intraoperatively.Methods: Preoperatively planned bone cuts, limb alignment, and component size were projected using a reconstructed 3D model. Intraoperative bone cuts and postoperative limb alignment were measured. Errors between planned and real bone cuts, limb alignment, and component size were compared.Results: The mean absolute errors for bone cuts and alignment were within 1.40mm/1.30° with a standard deviation (SD) of 0.96mm/1.12°. For all errors of bone cuts and alignment compared with the plan, there were no statistically significant differences except for the lateral distal of femoral cuts (P=0.004). The accuracy for predicting the femoral, tibial, and polyethylene component sizes was 100% (48/48), 90% (43/48), and 88% (42/48), respectively. Regarding all mean absolute errors of bone cuts and alignments, no significant differences were observed among surgeons.Conclusion: The novel robotically-assisted system for RATKA donated reliable operative decision-making based on the predictive accuracy regardless of the surgeon’s level of experience.Keywords: robotic surgery, total knee arthroplasty, resection, implant, level of experience