{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:03:19Z","timestamp":1788444199497,"version":"build-2803163510"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to compare the effect of an image-based (MAKO) system using a gap-balancing technique with an imageless (OMNIbot) robotic tool utilising a femur-first measured resection technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed on patients undergoing primary TKA with a functional alignment philosophy performed by a single surgeon using either the MAKO or OMNIbot robotic systems. In all cases, the surgeon\u2019s goal was to create a balanced knee and correct sagittal deformity (eliminate any fixed flexion deformity). Intra-operative data and patient-reported outcomes (PROMS) were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 207 MAKO TKA and 298 OMNIbot TKAs were analysed. MAKO TKA patients were younger (67 vs 69,\n                      <jats:italic>p<\/jats:italic>\n                      =0.002) than OMNIbot patients. There were no other demographic or pre-operative alignment differences. Regarding implant positioning, in MAKO TKAs the femoral component was more externally rotated in relation to the posterior condylar axis (2.3\u00b0 vs 0.1\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), had less valgus femoral cuts (1.6\u00b0 vs 2.7\u00b0 valgus, p&lt;0.001) and more varus tibial cuts (2.4\u00b0 vs 1.9\u00b0 varus,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001), and had more bone resected compared to OMNIbot TKAs. OMNIbot cases were more likely to require tibial re-cuts than MAKO (15% vs 2%,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). There were no differences in femur recut rates, soft tissue releases, or rate of achieving target coronal and sagittal leg alignment between robotic systems. A subgroup analysis of 100 MAKO and 100 OMNIbot propensity-matched TKAs with 12-month follow-up showed no significant difference in OKS (42 vs 43,\n                      <jats:italic>p<\/jats:italic>\n                      =0.7) or OKS PASS scores (83% vs 91%,\n                      <jats:italic>p<\/jats:italic>\n                      =0.1). MAKO TKAs reported significantly better symptoms according to their KOOS symptoms score than patients that had OMNIbot TKAs (87 vs 82,\n                      <jats:italic>p<\/jats:italic>\n                      =0.02) with a higher proportion of KOOS PASS rates, at a slightly longer follow-up time (20 months vs 14 months,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). There were no other differences in PROMS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A gap-balanced technique with an image-based robotic system (MAKO) results in different implant positioning and bone resection and reduces tibial recuts compared to a femur-first measured resection technique with an imageless robotic system (OMNIbot). Both systems achieve equal coronal and sagittal deformity correction and good patient outcomes at short-term follow-ups irrespective of these differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00264-022-05681-x","type":"journal-article","created":{"date-parts":[[2023,2,5]],"date-time":"2023-02-05T22:03:46Z","timestamp":1675634626000},"page":"1221-1232","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["How does the use of quantified gap-balancing affect component positioning and limb alignment in robotic total knee arthroplasty using functional alignment philosophy? 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Approval was granted by the Ethics Committee Northern Sydney Local Health District Human Research Ethics Committee (2019\/ETH08340).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"GM, JS, and JD declare no conflicts of interest.BF declares the following:","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}