Abstract
Total knee arthroplasty (TKA) is one of the most effective treatment options for patients
with end-stage osteoarthritis of the knee. However, one out of five patients remains
unhappy with the outcomes. In recent years, more emphasis has been given to knee alignment
approaches as a potential solution. The main objective of this study was to compare
the clinical and functional outcomes between patients undergoing robot-assisted TKA
using mechanical alignment (MA) or functional alignment (FA). This prospective nonrandomized
study enrolled 40 patients (20 patients in each group). The procedure was performed
by a single surgeon using FA or MA. In addition to other measures, the New Knee Society
Score (NKSS) and Oxford Knee Score (OKS), and modified forgotten joint scores (MFJS)
were recorded, and the patients were followed up until 18 months. The baseline characteristics,
including age, gender, and body mass index, did not differ statistically between the
groups. All parameters of the NKSS, the OKS, and the MFJS were improved at 18 months
in the FA-TKA group compared with the MA-TKA group. The pain score and time to straight
leg raise were better in the FA-TKA versus the MA-TKA group (p < 0.001). This study
suggests that robotic TKA with the FA approach could improve patient satisfaction,
along with fulfillment of patients' expectations from the surgery, through 18 months
of follow-up compared with the MA approach. Due to the small sample size of this study,
future studies are needed to confirm these findings.
Keywords total knee arthroplasty - robotic-assisted TKA - functional alignment - MAKO
