Minimized Soft Tissue Release in Robotic-Assisted Total Knee Arthroplasty: A Retrospective Review of 100 Cases

Abstract

Aim For a successful total knee arthroplasty (TKA), bone cuts and soft tissue envelope must be balanced to ensure equal flexion and extension gaps. The study aims to assess if preoperative computed tomography (CT) scans and planning software reduce soft tissue release. Methodology A retrospective analysis was conducted for the first 100 consecutive robotic-assisted (RA) TKA (RA-TKA) patients between March 2022 and May 2023. All patients underwent preoperative leg CT scans utilizing a fully automated Cuvis Joint robot. Planning software determined implant sizes and bone resections to achieve a 180° hip-knee-ankle axis. A posterior-stabilized knee design was implanted during surgery by the same surgical team using a medial parapatellar approach. The study hypothesis was, that RA-TKA with preoperative CT scans and planning does not reduce soft tissue release incidence, comparing it with the historical control cohort using chi-square tests (P < 0.05 considered significant). Results The study consisted of 89 women and 11 males, with an average age of 65.3 ± 12 years. The average body mass index of the patients was 27.4 ± 5.2 kg/m2. Ninety-four individuals had varus knees, while six had valgus knee deformity. Varus deformity ranged between 7° and 18°, and valgus knee deformity ranged from 6° to 14° preoperatively. Twelve patients (12.77%) of 94 varus knees (versus historic control 29%, P-value = 0.0047) and one out of 6 (16.67%) valgus knees (versus historic control 84%, P < 0.0001) required posteromedial and posterolateral release for appropriate knee balance. Conclusions The study negates the null hypothesis and indicates that RA-TKA with preoperative CT scans and planning reduces the incidence of soft tissue releases to achieve a well-balanced knee.