{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:16:49Z","timestamp":1791825409385,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Robotic\u2010assisted total knee arthroplasty (RATKA) has been connected to improved surgical precision and implant alignment compared to conventional TKA (CTKA), with limited evidence from randomised\u2010controlled trials (RCT) and a large range of different systems on the market. Consequently, this study aimed to compare RATKA using the ROSA\u00ae knee system and CTKA in a prospective RCT for surgical as well as patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010seven patients undergoing TKA were prospectively included in this monocentric, unblinded RCT. All patients had a minimum follow\u2010up of 1 year. Primary endpoints were postoperative implant alignment accuracy and patient\u2010reported outcomes using the Oxford knee score (OKS) and quality of life scoring (EQ\u20105D\u20105L). Secondary outcomes included range of motion, blood loss, length of stay, return to work and physiotherapy needs. Statistical analysis included multivariable regression with significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      RATKA lead to improved limb alignment with significant lower frequency of extreme malalignment (&gt;3\u00b0; &lt;\u22123\u00b0 from the mechanical axis) compared to CTKA (38% vs. 18%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). Both groups had comparable postoperative improvement in patient\u2010reported outcomes (OKS \u0394 prepost 18.0 vs. 17.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.902; EQ\u20105D\u20105L \u0394 prepost 0.21 vs. 0.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.089). Regression analysis identified preoperative OKS (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20090.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and cruciate\u2010retaining implant bearing (\n                      <jats:italic>b<\/jats:italic>\n                      \u2009=\u20095.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.043) as significant predictors of improved postoperative outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RATKA using the ROSA\u00ae knee system improves implant positioning and radiological alignment compared to CTKA with similar short\u2010term clinical outcomes. Future research should focus on long\u2010term RCT data to determine whether the improved accuracy of RATKA results in superior implant survival and reduced revision rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, prospective comparative study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70197","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:59:31Z","timestamp":1764601171000},"page":"2897-2905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Improved surgical accuracy in total knee arthroplasty using the ROSA\u00ae knee system: A randomised\u2010controlled unblinded trial"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5735-3004","authenticated-orcid":false,"given":"Alexander","family":"M\u00f6ller","sequence":"first","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Kasabji","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Fischer","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janosch","family":"Schoon","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Hofer","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgi Iwan","family":"Wassilew","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes Christian","family":"Reichert","sequence":"additional","affiliation":[{"name":"Center for Orthopedics, Trauma Surgery and Rehabilitation Medicine University Medicine Greifswald Greifswald 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