{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:35:25Z","timestamp":1792852525840,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T00:00:00Z","timestamp":1679702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T00:00:00Z","timestamp":1679702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T00:00:00Z","timestamp":1679702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005713","name":"Technische Universit\u00e4t M\u00fcnchen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Robotic arm\u2010assisted total knee arthroplasty (raTKA), currently a major trend in knee arthroplasty, aims to improve the accuracy of implant positioning and limb alignment. However, it is unclear whether and to what extent manual radiographic and navigation measurements with the MAKO\u2122 system correlate. Nonetheless, a high agreement would be crucial to reliably achieve the desired limb alignment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010six consecutive patients with osteoarthritis and a slight\u2010to\u2010moderate varus deformity undergoing raTKA were prospectively included in this study. Prior to surgery and at follow\u2010up, a full leg radiograph (FLR) under weight\u2010bearing conditions was performed. In addition, a computed tomography (CT) scan was conducted for preoperative planning. The hip\u2013knee\u2013ankle angle (HKA), mechanical lateral distal femur angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) and joint line convergence angle (JLCA) were measured in the preoperative and follow\u2010up FLR as well as in the CT scout (without weight\u2010bearing) by three independent raters. Furthermore, the HKA was intraoperatively assessed with the MAKO\u2122 system before and after raTKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significantly higher HKA values were identified for intraoperative deformity assessment using the MAKO system compared to the preoperative FLR and CT scouts (<jats:italic>p<\/jats:italic>\u2009=\u20090.006; <jats:italic>p<\/jats:italic>\u2009=\u20090.05). Intraoperative assessment of the HKA with final implants showed a mean residual varus deformity of 3.2\u00b0\u2009\u00b1\u20091.9\u00b0, whereas a significantly lower residual varus deformity of 1.4\u00b0\u2009\u00b1\u20091.9\u00b0 was identified in the postoperative FLR (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The mMPTA was significantly higher in the preoperative FLR than in the CT scouts (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Intraoperatively, the mMPTA was adjusted to a mean of 87.5\u00b0\u2009\u00b1\u20090.9\u00b0 with final implants, while significantly higher values were measured in postoperative FLRs (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Concerning the mLDFA, no significant differences could be identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The clinical importance of this study lies in the finding that there is a difference between residual varus deformity measured intraoperatively with the MAKO\u2122 system and those measured in postoperative FLRs. This has implications for preoperative planning as well as intraoperative fine\u2010tuning of the implant position during raTKA to avoid overcorrection of knees with slight\u2010to\u2010moderate varus osteoarthritis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07386-z","type":"journal-article","created":{"date-parts":[[2023,3,25]],"date-time":"2023-03-25T09:02:46Z","timestamp":1679734966000},"page":"3912-3918","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Postoperative full leg radiographs exhibit less residual coronal varus deformity compared to intraoperative measurements in robotic arm\u2010assisted total knee arthroplasty with the MAKO\u2122 system"],"prefix":"10.1002","volume":"31","author":[{"given":"Claudio","family":"Glowalla","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"},{"name":"<!--<label>2<\/label>--> BG Unfallklinik Murnau Professor\u2010Kuentscher\u2010Strasse 8 82418 Murnau am Staffelsee Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severin","family":"Langer","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"},{"name":"<!--<label>2<\/label>--> BG Unfallklinik Murnau Professor\u2010Kuentscher\u2010Strasse 8 82418 Murnau am Staffelsee Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Lenze","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Lazic","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T.","family":"Hirschmann","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopaedic Surgery and Traumatology Kantonsspital Baselland (BruderholzLiestalLaufen) 4101 Bruderholz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Hinterwimmer","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"von Eisenhart\u2010Rothe","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8867-2973","authenticated-orcid":false,"given":"Florian","family":"Pohlig","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery, Klinikum Rechts der Isar Technical University Munich Ismaninger\u2010Strasse 22 81675 Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,25]]},"reference":[{"issue":"3393","key":"e_1_2_11_2_2","article-title":"Clinical and radiological outcomes in robotic\u2010assisted total knee arthroplasty: a systematic 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