{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:17:49Z","timestamp":1788441469661,"version":"build-2803163510"},"reference-count":23,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose: Robotic-assisted total knee arthroplasty (rTKA) has been proposed to improve component positioning but evidence on its effect on implant survival is limited. We aimed to compare implant survival between rTKA and conventional total knee arthroplasty (cTKA) overall and due to peri-prosthetic joint infection (PJI).Methods: We included all rTKAs performed in Finland from April 2021 until May 2023, all implanted with Triathlon TKA using MAKO robotic-arm assist. Propensity score matching was used to form a control group with similar characteristics for the same time period. Primary survival endpoint was first revision due to any cause within 12 months after the index surgery. PJI and non-PJI revisions were considered secondary outcomes. Kaplan\u2013Meier (KM) analysis and Cox proportional hazards regression were used to assess implant survival and between-group contrasts hazard ratios (HR) with 95% confidence intervals (CIs), respectively.Results: 1,318 fixed bearing rTKAs were compared with a control group of 1,318 cTKAs. Revision-free survival at 12 months after index surgery did not differ between groups. KM estimates were 99.1% (CI 98.5\u201399.7) for rTKA and 98.6% (CI 98.0\u201399.3) for cTKA with HR 0.61 (CI 0.28\u20131.34). The rTKA group demonstrated better PJI-free survival at 12 months (HR 0.29, CI 0.10\u20130.90). Overall, PJI was the most common reason for revision. At the end of available follow-up, the estimated overall survival was 97.7% (CI 94.9\u2013100.0) for rTKA and 97.9% (CI 96.6\u201399.2) for cTKA.Conclusion: No difference in all-cause revision risk was observed between rTKA and cTKA groups. However, within the first 12 months, fewer revisions due to PJI occurred in the rTKA group.<\/jats:p>","DOI":"10.2340\/17453674.2026.46462","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:49:33Z","timestamp":1788439773000},"source":"Crossref","is-referenced-by-count":0,"title":["Early revision rate in robotic-assisted versus conventional total knee arthroplasty: a prospective cohort study 2021\u20132023 from the Finnish Arthroplasty Register"],"prefix":"10.2340","volume":"97","author":[{"given":"Kasperi Juhani","family":"Alakyl\u00e4","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Sylvestersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1777-4259","authenticated-orcid":false,"given":"Mikko S","family":"Ven\u00e4l\u00e4inen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0302-0253","authenticated-orcid":false,"given":"Antti P","family":"Eskelinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Jaroma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Outi","family":"V\u00e4yrynen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Kukkonen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keijo T","family":"M\u00e4kel\u00e4","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"167267","doi-asserted-by":"crossref","unstructured":"Katz J N, Arant K R, Loeser R F. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA 2021; 325(6): 568-78. doi: 10.1001\/JAMA.2020.22171.","DOI":"10.1001\/jama.2020.22171"},{"key":"167268","doi-asserted-by":"crossref","unstructured":"Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol Surg Res 2018; 104(1S): S41-S46. doi: 10.1016\/J.OTSR.2017.04.017.","DOI":"10.1016\/j.otsr.2017.04.017"},{"key":"167269","doi-asserted-by":"crossref","unstructured":"Laigaard J, Aljuboori S M, Nikolajsen L, Mathiesen O, Lunn T H, Lindber-Larsen M, et al. View of chronic pain after primary total and medial unicompartmental knee arthroplasty for osteoarthritis: a Danish nationwide cross-sectional survey. Acta Orthop 2025; 96: 814-21. doi: 10.2340\/17453674.2025.44898.","DOI":"10.2340\/17453674.2025.44898"},{"key":"167270","doi-asserted-by":"crossref","unstructured":"Zhang J, Ndou W S, Ng N, Gaston P, Simpson P M, Macpherson G J, et al. Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 2021; 30(8): 2677. doi: 10.1007\/S00167-021-06464-4.","DOI":"10.1007\/s00167-021-06464-4"},{"key":"167271","unstructured":"FAR. Finnish arthroplasty register. [Finnish institute for Health and Welfare (Internet)]. 2022 [accessed 2022-05-15]. Available from: https:\/\/www.thl.fi\/far\/#index"},{"key":"167272","doi-asserted-by":"crossref","unstructured":"Springer B D, Cahue S, Etkin C D, Lewallen D G, McGrory B J. Infection burden in total hip and knee arthroplasties: an international registry-based perspective. Arthroplast Today 2017; 3(2): 137. doi: 10.1016\/J.ARTD.2017.05.003.","DOI":"10.1016\/j.artd.2017.05.003"},{"key":"167273","doi-asserted-by":"crossref","unstructured":"Dyrhovden G S, Lygre S H L, Badawy M, G\u00f8thesen \u00d8, Furnes O. Have the causes of revision for total and unicompartmental knee arthroplasties changed during the past two decades? Clin Orthop Relat Res 2017; 475(7): 1874-86. doi: 10.1007\/S11999-017-5316-7.","DOI":"10.1007\/s11999-017-5316-7"},{"key":"167274","doi-asserted-by":"crossref","unstructured":"Ruangsomboon P, Ruangsomboon O, Isaranuwatchai W, Zywiel M G, Naimark D M J. Cost-effectiveness of robotic-assisted versus conventional total knee arthroplasty: an analysis from a middle income country. Acta Orthop 2025; 96: 716-25. doi: 10.2340\/17453674.2025.44753.","DOI":"10.2340\/17453674.2025.44753"},{"key":"167275","doi-asserted-by":"crossref","unstructured":"Ranstam J, Robertsson O. Statistical analysis of arthroplasty register data. Acta Orthop 2010; 81(1): 10-14. doi: 10.3109\/17453671003587168.","DOI":"10.3109\/17453671003587168"},{"key":"167276","doi-asserted-by":"crossref","unstructured":"Grambsch P M, Therneau T M. Proportional hazards tests and diagnostics based on weighted residuals. Biometrika 1994; 81(3): 515-26. doi: 10.1093\/BIOMET\/81.3.515.","DOI":"10.1093\/biomet\/81.3.515"},{"key":"167277","doi-asserted-by":"crossref","unstructured":"Ranstam J, K\u00e4rrholm J, Pulkkinen P, M\u00e4kel\u00e4 K, Espehaug B, Pedersen A B, et al. Statistical analysis of arthroplasty data. II. Guidelines. Acta Orthop 2011; 82(3): 258-67. doi: 10.3109\/17453674.2011.588863.","DOI":"10.3109\/17453674.2011.588863"},{"key":"167278","doi-asserted-by":"crossref","unstructured":"Ofa S A, Ross B J, Flick T R, Patel A H, Sherman W F. Robotic total knee arthroplasty vs conventional total knee arthroplasty: a nationwide database study. Arthroplast Today 2020; 6(4): 1001. doi: 10.1016\/J.ARTD.2020.09.014.","DOI":"10.1016\/j.artd.2020.09.014"},{"key":"167279","doi-asserted-by":"crossref","unstructured":"Aggarwal V A, Sun J, Sambandam S N. Outcomes following robotic assisted total knee arthroplasty compared to conventional total knee arthroplasty. Arch Orthop Trauma Surg 2024; 144(5): 2223-7. doi: 10.1007\/S00402-024-05231-7.","DOI":"10.1007\/s00402-024-05231-7"},{"key":"167280","doi-asserted-by":"crossref","unstructured":"Wang J C, Piple A S, Hill W J, Chen M S, Gettleman B S, Richardson M, et al. Computer-navigated and robotic-assisted total knee arthroplasty: increasing in popularity without increasing complications. J Arthroplasty 2022; 37(12): 2358-64. doi: 10.1016\/J.ARTH.2022.06.014.","DOI":"10.1016\/j.arth.2022.06.014"},{"key":"167281","unstructured":"AOANJRR. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, knee & shoulder arthroplasty: 2019 annual report. Adelaide; 2025."},{"key":"167282","doi-asserted-by":"crossref","unstructured":"Kayani B, Konan S, Pietrzak J R T, Tahmassebi J, Haddad F S. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. Bone Joint J 2018; 100-B(7): 930-7. doi: 10.1302\/0301-620X.100B7.BJJ-2017-1449.R1.","DOI":"10.1302\/0301-620X.100B7.BJJ-2017-1449.R1"},{"key":"167283","doi-asserted-by":"crossref","unstructured":"Mitchell J, Wang J, Bukowski B, Greiner J, Wolford B, Oyer M, et al. Relative clinical outcomes comparing manual and robotic-assisted total knee arthroplasty at minimum 1-year follow-up. HSS J 2021; 17(3): 267-73. doi: 10.1177\/15563316211028568.","DOI":"10.1177\/15563316211028568"},{"key":"167284","doi-asserted-by":"crossref","unstructured":"Clement N D, Galloway S, Baron Y J, Smith K, Weir D J, Deehan D J. Robotic arm-assisted versus manual (ROAM) total knee arthroplasty: a randomized controlled trial. Bone Joint J 2023; 105-B(9): 961-70. doi: 10.1302\/0301-620X.105B9.BJJ-2023-0006.R3.","DOI":"10.1302\/0301-620X.105B9.BJJ-2023-0006.R3"},{"key":"167285","doi-asserted-by":"crossref","unstructured":"Vermue H, Batailler C, Monk P, Haddad F, Luyckx T, Lustig S. The evolution of robotic systems for total knee arthroplasty, each system must be assessed for its own value: a systematic review of clinical evidence and meta-analysis. Arch Orthop Trauma Surg 2023; 143(6): 3369-81. doi: 10.1007\/S00402-022-04632-W.","DOI":"10.1007\/s00402-022-04632-w"},{"key":"167286","doi-asserted-by":"crossref","unstructured":"Batailler C, Fernandez A, Swan J, Servien E, Haddad F S, Catani F, et al. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc [Internet] 2021; 29(11): 3585-98. doi: 10.1007\/S00167-020-06283-Z.","DOI":"10.1007\/s00167-020-06283-z"},{"key":"167287","doi-asserted-by":"crossref","unstructured":"Vermue H, Luyckx T, Winnock de Grave P, Ryckaert A, Cools A S, Himpe N, et al. Robot-assisted total knee arthroplasty is associated with a learning curve for surgical time but not for component alignment, limb alignment and gap balancing. Knee Surg Sports Traumatol Arthrosc 2022; 30(2): 593-602. doi: 10.1007\/S00167-020-06341-6.","DOI":"10.1007\/s00167-020-06341-6"},{"key":"167288","doi-asserted-by":"crossref","unstructured":"Keemu H, Alakyl\u00e4 K J, Kl\u00e9n R, Panula V J, Ven\u00e4l\u00e4inen M S, Haapakoski J J, et al. Risk factors for revision due to prosthetic joint infection following total knee arthroplasty based on 62,087 knees in the Finnish Arthroplasty Register from 2014 to 2020. Acta Orthop 2023; 94: 215-23. doi: 10.2340\/17453674.2023.12307.","DOI":"10.2340\/17453674.2023.12307"},{"key":"167289","doi-asserted-by":"crossref","unstructured":"Badawy M, Espehaug B, Indrekvam K, Engesaeter L B, Havelin L I, Furnes O. Influence of hospital volume on revision rate after total knee arthroplasty with cement. 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