title: Robot-assisted total knee arthroplasty.
abstract: Increasing evidence suggests performing total knee arthroplasty using computer navigation can lead to more accurate surgical positioning of the components and knee alignment compared to a conventional operating technique without computer assistance. The use of robotic technology could theoretically take this accuracy one level further because it uses navigation in combination with ultimate mechanical precision, which could eliminate or reduce the inevitable margin of error during mechanical preparation of the bony cuts of total knee arthroplasty by the surgeon. We prospectively followed 25 consecutive cases using an active surgical robot. The minimum followup was 5.1 years (mean, 5.5 years; range, 5.1-5.8 years). Our results demonstrate excellent implant positioning and alignment was achieved within the 1 degree error of neutral alignment in all three planes in all cases. Despite this technical precision, the excessive operating time required for the robotic implantation, the technical complexity of the system, and the extremely high operational costs have led us to abandon this procedure and direct our interest more toward smart semiactive robotic systems.
  
  
  METHODS
  Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: University Hospitals of the Catholic University, Leuven, Belgium. johan.bellemans@skynet.be
authors.forename: Johan
authors.initials: J
authors.lastname: Bellemans
authors.forename: Hilde
authors.initials: H
authors.lastname: Vandenneucker
authors.forename: Johan
authors.initials: J
authors.lastname: Vanlauwe
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D015203:Reproducibility of Results; D012371:Robotics / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome