{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:28:48Z","timestamp":1790864928457,"version":"4.1.0"},"reference-count":40,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"Stryker Orthopaedics"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Component position of total knee arthroplasty (TKA) has been shown to influence prosthetic survivorships and clinical outcomes. Our objective was to compare the three-dimensional accuracy to plan of robotic-arm assisted TKA (RATKA) with conventional TKA for component position. We conducted a nonrandomized, prospective study comparing 143 RATKA with 86 conventional TKA operated at four U.S. centers between July 2016 and October 2018. Computed tomography (CT) scans obtained approximately 6 weeks postoperatively were analyzed using anatomical landmarks. Absolute deviation from surgical plans were defined as the absolute value of the difference between the CT measurements and surgeons' femoral and tibial component mechanical varus\/valgus alignment, tibial component posterior slope, and femoral component internal\/external rotation. Differences of absolute deviations were tested using stratified Wilcoxon's tests that controlled for study center. Patient-reported outcome measures collected through 1 postoperative year were modeled using multiple regression controlling for age, sex, body mass index, study center, and the preoperative score. RATKA demonstrated greater accuracy for tibial component alignment (median [25th, 75th percentiles] absolute deviation from plan of all centers combined for conventional vs. RA, 1.7 [0.9, 2.9] vs. 0.9 [0.4, 1.9] degrees, p\u2009&lt;\u20090.001), femoral component rotation (1.5 [0.9, 2.5] vs. 1.3 [0.6, 2.5] degrees, p\u2009=\u20090.015), and tibial slope (2.9 [1.5, 5.0] vs. 1.1 [0.6, 2.0] degrees, p\u2009&lt;\u20090.001). In multivariable analyses, RATKA showed significantly greater Veterans RAND 12-item health survey (VR-12) physical component scores (adjusted mean difference [95% confidence interval (CI)]: 2.4 [0.2, 4.5] points, p\u2009=\u20090.034) and qualitatively greater Knee Society (KS) composite functional scores (3.5 [\u22121.3, 8.2] points, p\u2009=\u20090.159), though not statistically significant. Compared with conventional instrumentation, RATKA demonstrated greater three-dimensional accuracy to plan for various component positioning parameters and clinical improvements in physical status and function with no major safety concerns during the first postoperative year. These results may be attributed to the preoperative CT scan planning, real-time intraoperative feedback, and stereotactic-guided cutting that takes into consideration patient-specific bony anatomy. These findings support the use of RATKA for enhanced arthroplasty outcomes.<\/jats:p>","DOI":"10.1055\/s-0040-1715571","type":"journal-article","created":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T20:17:33Z","timestamp":1598905053000},"page":"337-344","source":"Crossref","is-referenced-by-count":85,"title":["Improved Component Placement Accuracy with Robotic-Arm Assisted Total Knee Arthroplasty"],"prefix":"10.1055","volume":"35","author":[{"given":"Ormonde","family":"Mahoney","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Athens Orthopaedic Clinc, Athens, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Kinsey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Athens Orthopaedic Clinc, Athens, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nipun","family":"Sodhi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Mont","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Northwell Hospital Lenox Hill, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia F.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Rothman Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Orozco","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Rothman Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hozack","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Rothman Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.arth.2008.02.018","article-title":"Does accurate anatomical alignment result in better function and quality of life? Comparing conventional and computer-assisted total knee arthroplasty","volume":"24","author":"P F Choong","year":"2009","journal-title":"J Arthroplasty"},{"issue":"428","key":"ref2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/01.blo.0000148578.22729.0e","article-title":"Tibial component failure mechanisms in total knee arthroplasty","author":"M E Berend","year":"2004","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"160","DOI":"10.3109\/17453678408992329","article-title":"Total condylar knee arthroplasty. Prosthetic component positioning and radiolucent lines","volume":"55","author":"I Hvid","year":"1984","journal-title":"Acta Orthop Scand"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1302\/0301-620X.73B5.1894655","article-title":"Coronal alignment after total knee replacement","volume":"73","author":"R S Jeffery","year":"1991","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2106\/00004623-197759010-00013","article-title":"Influence of positioning of prosthesis in total knee replacement","volume":"59","author":"P A Lotke","year":"1977","journal-title":"J Bone Joint Surg Am"},{"issue":"226","key":"ref6","first-page":"49","article-title":"Mechanisms of failure in total knee arthroplasty","author":"J R Moreland","year":"1988","journal-title":"Clin Orthop Relat Res"},{"issue":"17","key":"ref7","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.2106\/JBJS.J.00772","article-title":"The effect of alignment and BMI on failure of total knee replacement","volume":"93","author":"M A Ritter","year":"2011","journal-title":"J Bone Joint Surg Am"},{"issue":"299","key":"ref8","first-page":"153","article-title":"Postoperative alignment of total knee replacement. Its effect on survival","author":"M A Ritter","year":"1994","journal-title":"Clin Orthop Relat Res"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"963","DOI":"10.2106\/00004623-200405000-00012","article-title":"Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature","volume":"86","author":"O Ethgen","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"01","key":"ref10","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1302\/0301-620X.97B1.34440","article-title":"A comparison of patient-specific and conventional instrumentation for total knee arthroplasty: a multicentre randomised controlled trial","volume":"97-B","author":"L Abane","year":"2015","journal-title":"Bone Joint J"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s11999-014-3804-6","article-title":"Systematic review of patient-specific instrumentation in total knee arthroplasty: new but not improved","volume":"473","author":"A Sassoon","year":"2015","journal-title":"Clin Orthop Relat Res"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s11999-012-2528-8","article-title":"Computer-assisted total knee arthroplasty is currently of no proven clinical benefit: a systematic review","volume":"471","author":"R S Burnett","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1053\/j.oto.2012.12.001","article-title":"Robotically assisted unicompartmental knee arthroplasty","volume":"22","author":"J H Lonner","year":"2012","journal-title":"Oper Tech Orthop"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.knee.2012.11.001","article-title":"Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique?","volume":"20","author":"M Citak","year":"2013","journal-title":"Knee"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/j.arth.2011.09.021","article-title":"Accuracy of dynamic tactile-guided unicompartmental knee arthroplasty","volume":"27","author":"N J Dunbar","year":"2012","journal-title":"J Arthroplasty"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"837167","DOI":"10.1155\/2013\/837167","article-title":"Achieving accurate ligament balancing using robotic-assisted unicompartmental knee arthroplasty","volume":"2013","author":"J F Plate","year":"2013","journal-title":"Adv Orthop"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1055\/s-0038-1641729","article-title":"Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques","volume":"32","author":"E L Hampp","year":"2019","journal-title":"J Knee Surg"},{"key":"ref18","first-page":"441","article-title":"Robotic-arm assisted total knee arthroplasty demonstrated soft tissue protection","volume":"30","author":"A Khlopas","year":"2017","journal-title":"Surg Technol Int"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1302\/2046-3758.810.BJR-2019-0129.R1","article-title":"Less iatrogenic soft-tissue damage utilizing robotic-assisted total knee arthroplasty when compared with a manual approach: A blinded assessment","volume":"8","author":"E L Hampp","year":"2019","journal-title":"Bone Joint Res"},{"issue":"07","key":"ref20","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1055\/s-0039-1684014","article-title":"Patient-reported functional and satisfaction outcomes after robotic-arm-assisted total knee arthroplasty: early results of a prospective multicenter investigation","volume":"33","author":"A Khlopas","year":"2020","journal-title":"J Knee Surg"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1016\/j.arth.2018.01.060","article-title":"Robotic arm-assisted total knee arthroplasty","volume":"33","author":"A Khlopas","year":"2018","journal-title":"J Arthroplasty"},{"issue":"08","key":"ref22","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1055\/s-0038-1668122","article-title":"Does the robotic arm and preoperative CT planning help with 3D intraoperative total knee arthroplasty planning?","volume":"32","author":"R C Marchand","year":"2019","journal-title":"J Knee Surg"},{"issue":"09","key":"ref23","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1055\/s-0037-1607450","article-title":"Patient satisfaction outcomes after robotic arm-assisted total knee arthroplasty: a short-term evaluation","volume":"30","author":"R C Marchand","year":"2017","journal-title":"J Knee Surg"},{"key":"ref24","first-page":"276","article-title":"New technology for total knee arthroplasty provides excellent patient-reported outcomes: a minimum two-year analysis","volume":"36","author":"A L Malkani","year":"2020","journal-title":"Multicenter Study"},{"key":"ref25","first-page":"336","article-title":"Manipulation under anesthesia rates in technology-assisted versus conventional-instrumentation total knee arthroplasty","volume":"36","author":"A L Malkani","year":"2019","journal-title":"Surg Technol Int"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"236","DOI":"10.2106\/JBJS.F.00386","article-title":"A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation","volume":"89","author":"G Matziolis","year":"2007","journal-title":"J Bone Joint Surg Am"},{"issue":"06","key":"ref27","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1302\/0301-620X.86B6.15456","article-title":"Computer-assisted total knee replacement. A controlled cadaver study using a multi-parameter quantitative CT assessment of alignment (the Perth CT Protocol)","volume":"86","author":"S K Chauhan","year":"2004","journal-title":"J Bone Joint Surg Br"},{"issue":"01","key":"ref28","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s11999-011-2152-z","article-title":"Development of a new Knee Society scoring system","volume":"470","author":"P C Noble","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"01","key":"ref29","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11999-011-2135-0","article-title":"The new knee society knee scoring system","volume":"470","author":"G R Scuderi","year":"2012","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1097\/00004479-200604000-00011","article-title":"Applications of methodologies of the Veterans Health Study in the VA healthcare system: conclusions and summary","volume":"29","author":"L E Kazis","year":"2006","journal-title":"J Ambul Care Manage"},{"issue":"03","key":"ref32","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity","volume":"34","author":"J Ware Jr","year":"1996","journal-title":"Med Care"},{"issue":"07","key":"ref33","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.spinee.2018.02.023","article-title":"Assessment of health-related quality of life in spine treatment: conversion from SF-36 to VR-12","volume":"18","author":"M F Gornet","year":"2018","journal-title":"Spine J"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"P A Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0197-2456(86)90034-6","article-title":"Analysis of data from multiclinic trials","volume":"7","author":"J L Fleiss","year":"1986","journal-title":"Control Clin Trials"},{"issue":"05","key":"ref36","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/art.1780370512","article-title":"Differences between men and women undergoing major orthopedic surgery for degenerative arthritis","volume":"37","author":"J N Katz","year":"1994","journal-title":"Arthritis Rheum"},{"issue":"11","key":"ref37","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1055\/s-0039-1683977","article-title":"One-year patient outcomes for robotic-arm-assisted versus manual total knee arthroplasty","volume":"32","author":"R C Marchand","year":"2019","journal-title":"J Knee Surg"},{"issue":"12","key":"ref38","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1080\/17434440.2017.1392237","article-title":"Utilization of robotic-arm assisted total knee arthroplasty for soft tissue protection","volume":"14","author":"A A Sultan","year":"2017","journal-title":"Expert Rev Med Devices"},{"issue":"05","key":"ref39","doi-asserted-by":"crossref","first-page":"e822","DOI":"10.3928\/01477447-20160623-13","article-title":"Robotic total knee arthroplasty: surgical assistant for a customized normal kinematic knee","volume":"39","author":"K L Urish","year":"2016","journal-title":"Orthopedics"},{"issue":"11","key":"ref41","doi-asserted-by":"crossref","first-page":"2799","DOI":"10.1016\/j.arth.2019.06.040","article-title":"Accuracy of a new robotically assisted technique for total knee arthroplasty: a cadaveric study","volume":"34","author":"S Parratte","year":"2019","journal-title":"J Arthroplasty"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"98","DOI":"10.29007\/4rzz","article-title":"Technique and accuracy assessment of a novel image-free handheld robot for knee arthroplasty in bi-cruciate retaining total knee replacement","volume":"2","author":"B Jaramaz","year":"2018","journal-title":"EPIC Ser Health Sci"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1715571.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T23:21:12Z","timestamp":1668208872000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1715571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,31]]},"references-count":40,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,2,11]]},"published-print":{"date-parts":[[2022,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1715571","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,31]]}}}