{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:15:53Z","timestamp":1791040553879,"version":"4.1.0"},"reference-count":45,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Octogenarians undergoing unicompartmental knee arthroplasty (UKA) face increased risks of complications due to reduced bone support following osteoporosis. The aim of this study was to describe our preferred technique to balance robotic-assisted UKA in this specific patient population and to present its results. Methods: This retrospective analysis of prospectively collected data examined 121 consecutive octogenarian patients (median age 84 years, IQR 82\u201386) who underwent robotic-assisted medial UKA between September 2018 and December 2022 with \u226524 months follow-up. Patients aged \u226480 years, with \u22642 years of follow-up, or without informed consent were excluded. Data collection included radiographic measurements (HKA, LDFA, MPTA, joint line height), patient-reported outcome measures (Oxford Knee Score, Knee Society Score), and complications. Statistical analysis employed descriptive statistics, paired t-tests, Cohen\u2019s d for effect sizes, and the McNemar test for categorical variables. Results: The hip\u2013knee\u2013ankle angle improved significantly from 174.43\u00b0 to 178.04\u00b0 (mean difference 3.61\u00b0, 95% CI 3.13\u20134.09, p &lt; 0.001). Patient-reported outcomes demonstrated substantial improvements: the Knee Society Score increased by 83.09 points (95% CI 79.76\u201386.42, p &lt; 0.001, Cohen\u2019s d = 4.53), and the Oxford Knee Score increased by 17.09 points (95% CI 15.42\u201318.76, p &lt; 0.001), with both exceeding minimal clinically important differences. Only 7.4% (9\/121) of cases exhibited joint line lowering of &gt;2 mm, with 1.7% (2\/121) having both post-operative HKA &lt;175\u00b0 and joint line lowering of &gt;2 mm. The implant survival rate was 100% with minimal complications, including two conservatively managed tibial plateau fractures and two cases of wound dehiscence with no further surgery needed. Conclusions: Robotic-assisted medial UKA can consistently preserve joint line height while achieving excellent alignment correction and clinical outcomes in octogenarians, potentially addressing failure risks in this specific population.<\/jats:p>","DOI":"10.3390\/jpm15080362","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T09:56:42Z","timestamp":1754647002000},"page":"362","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Robotic-Assisted Joint Line Preserving Unicompartmental Knee Arthroplasty Positioning Among Octogenarians"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1289-8849","authenticated-orcid":false,"given":"Filippo","family":"Leggieri","sequence":"first","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7091-670X","authenticated-orcid":false,"given":"Fernando Nahuel","family":"Mart\u00edn Cocilova","sequence":"additional","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Civinini","sequence":"additional","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Stimolo","sequence":"additional","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0010-7532","authenticated-orcid":false,"given":"Roberto","family":"Civinini","sequence":"additional","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9604-2042","authenticated-orcid":false,"given":"Matteo","family":"Innocenti","sequence":"additional","affiliation":[{"name":"Department of Clinical Orthopaedic, University of Florence, A.O.U. Careggi CTO, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2014","DOI":"10.1016\/j.arth.2022.04.032","article-title":"Significant Reduction in Short-Term Complications Following Unicompartmental Versus Total Knee Arthroplasty: A Propensity Score Matched Analysis","volume":"37","author":"Gowd","year":"2022","journal-title":"J. Arthroplast."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3656","DOI":"10.1016\/j.arth.2021.06.014","article-title":"Octogenarians Undergoing Medial Unicompartmental Knee Arthroplasty Have Similar Patient-Reported Outcomes as Their Younger Counterparts","volume":"36","author":"Goh","year":"2021","journal-title":"J. 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