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Abstract
Total knee replacement (TKR) is a common procedure for treatment of severe gonarthrosis,
but the outcome may be unsatisfactory due to primary malalignment of the prosthetic
components. In order to improve precision and accuracy of this surgical procedure,
a commercial robotic surgical system (CASPAR) has been adapted to assist the surgeon
in the preoperative planning and intraoperative execution of TKR. So far, 70 patients
with idiopathic gonarthrosis were successfully treated with a robot-assisted technique
in our institution. No major adverse events related to the use of the robotic system
have been observed. The mean difference between preoperatively planned and postoperatively
achieved tibiofemoral alignment was 0.8 degrees (0-4.1 degrees ) in the robotic group
vs. 2.6 degrees (0-7 degrees ) in a manually operated historical control group of
50 patients. A clear advantage of robot-assisted TKR seems to be the ability to execute
a highly precise preoperative plan based on computed tomography (CT) scans. Due to
better alignment of the prosthetic components and improved bone-implant fit, implant
loosening is anticipated to be diminished which may be most evident in non-cemented
prostheses. Current disadvantages such as the need for placement of fiducial markers,
increased operating times and higher overall costs have to be resolved in the future.