Short-term benefits of image-based robotic assistance in TKA after prior HTO: A comparative study.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42292691.
- Also identified by DOI 10.1002/jeo2.70757 and PMC identifier 13256262.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
High tibial osteotomy (HTO) is used to treat medial knee osteoarthritis with varus alignment in young, active patients. While robotic-assisted total knee arthroplasty (TKA) may improve implant positioning and soft-tissue balance, its benefits in post-HTO patients remain unclear. This study compares surgical, clinical and radiological outcomes between robotic-assisted and conventional TKA following HTO. A retrospective study included 87 patients with prior HTO who underwent TKA between August 2017 and October 2023 (46 robotic-assisted and 41 conventional), with a minimum 1-year follow-up. Demographic data, surgical characteristics, clinical outcomes (Knee Society Score [KSS], range of motion), radiological alignment (hip-knee-ankle angle) and complications were analysed. Mean follow-up was 23 months. Operative time was similar between groups (82 vs. 95 min; <i>p</i> = 0.07). Robotic-assisted TKA was associated with fewer lateral releases (30% vs. 54%; <i>p</i> = 0.03) and no tibial tubercle osteotomies (0% vs. 10%; <i>p</i> = 0.03). Cruciate-substituting implants were used more frequently in the robotic group (13% vs. 0%; <i>p</i> = 0.001), whereas stemmed implants were more common in the conventional group (49% vs. 17%; <i>p</i> = 0.001). Postoperative KSS Knee scores were comparable between groups (<i>p</i> = 0.28), while KSS Function scores were slightly higher in the conventional group (<i>p</i> = 0.048). Complication rates did not differ significantly. Robotic-assisted TKA after HTO was associated with a similar operative times and comparable short-term clinical outcomes to conventional TKA. It was also associated with lower rates of additional procedures and a less frequent use of stemmed or constrained implants. These findings should be interpreted with caution, given the baseline differences between the groups. Longer follow-up is warranted. Level III, therapeutic studies, retrospective comparative study.