Functional alignment in robotic-assisted total knee arthroplasty: a systematic review.

Migliorini, Filippo; Pilone, Marco; Schäfer, Luise; Simeone, Francesco; Bell, Andreas; Maffulli, Nicola

Abstract

The present study systematically reviewed current evidence on functional alignment (FA) in robotic total knee arthroplasty (TKA), discussing advantages and limitations, possible pitfalls, and prospects. This study was conducted according to the 2020 PRISMA statement. In August 2023, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase with no additional filters or time constraints. All the clinical studies investigating functional alignment in robotic TKA were accessed. Only studies published in peer-reviewed journals were considered. The risk of bias was evaluated following the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. Non-randomized controlled trials (non-RCTs) were evaluated using the Risk of Bias in Nonrandomised Studies of Interventions (NRSI) (ROBINS-I) tool. Data from 1198 patients (seven studies) were retrieved. The mean length of the follow-up was 17.1 ± 6.4 months. The mean age was 67.2 ± 5.4 years, and the mean BMI was 30.9 ± 2.7 kg/m . FA might improve resection accuracy, implant alignment, and gap balancing in TKA, and additional high-quality clinical trials are necessary to properly establish the superiority of FA to other alignment techniques in TKA. Long-term clinical trials are needed to investigate the impact of FA on implant survivorship. Level IV, systematic review and meta-analysis. [Abstract copyright: © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.]

Citation

Migliorini, F., Pilone, M., Schäfer, L., Simeone, F., Bell, A., & Maffulli, N. (in press). Functional alignment in robotic-assisted total knee arthroplasty: a systematic review. Archives of Orthopaedic and Trauma Surgery, 10.1007/s00402-023-05195-0. https://doi.org/10.1007/s00402-023-05195-0

• Journal Article Type: Article
• Acceptance Date: Dec 21, 2023
• Online Publication Date: Feb 10, 2024
• Deposit Date: Feb 26, 2024
• Journal: Archives of orthopaedic and trauma surgery
• Print ISSN: 0936-8051
• Electronic ISSN: 1434-3916
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Pages: 10.1007/s00402-023-05195-0
• DOI: https://doi.org/10.1007/s00402-023-05195-0
• Keywords: Functional alignment, Total knee arthroplasty, TKA, Robotic
• Publisher URL: https://link.springer.com/article/10.1007/s00402-023-05195-0