PURPOSE Robotically-assisted total knee arthroplasty (TKA) has been shown to improve alignment and decrease outliers, an important goal in TKA procedures. The purpose of this cadaveric study was to compare the accuracy and reproducibility of a recently introduced TKA robotic system to conventional instrumentation for bone resections. METHODS This cadaveric study compared 14 robotically-assisted TKA with 20 conventional TKAs. Four board-certified high volume arthroplasty surgeons with no prior experience in robotics (except one) performed the procedures with three different implant systems. Angle and level of bone resections obtained from optical navigation or calliper measurements were compared to the intra-operative plan to determine accuracy. Group comparison was performed using Student t test (mean) and F test (variance), with significance at p < 0.05. RESULTS The robotic group demonstrated statistically more accurate results (p < 0.05) and fewer outliers (p < 0.05) than conventional instrumentation when aiming for neutral alignment. Final limb alignment (HKA) had an accuracy of 0.8° ± 0.6° vs 2.0° ± 1.6°, with 100% vs 75% of cases within 3° and 93% vs 60% within 2°. For the robotically-assisted knees, the accuracy of bone resection angles was below 0.6° with standard deviations below 0.4°, except for the femur flexion (1.3° ± 1.0°), and below 0.7 mm with standard deviations below 0.7 mm for bone resection levels. CONCLUSION This in vitro study has demonstrated that this novel TKA robotic system produces more accurate and more reproducible bone resections than conventional instrumentation. It supports the clinical use of this new robotic system. LEVEL OF EVIDENCE Cadaveric study, Level V.

中文翻译：

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与传统器械相比，用于全膝关节置换术的新型机器人辅助系统具有更好的准确性和可重复性：尸体研究。

目的 机器人辅助全膝关节置换术 (TKA) 已被证明可以改善对齐并减少异常值，这是 TKA 手术的一个重要目标。这项尸体研究的目的是比较最近推出的 TKA 机器人系统与传统骨切除器械的准确性和可重复性。方法 这项尸体研究将 14 例机器人辅助 TKA 与 20 例传统 TKA 进行了比较。四名获得委员会认证的大容量关节成形术外科医生（一名除外）在机器人技术方面没有任何经验，使用三种不同的植入系统进行手术。将从光学导航或卡尺测量中获得的骨切除角度和水平与术中计划进行比较以确定准确性。使用学生 t 检验（平均值）和 F 检验（方差）进行组比较，在 p < 0.05 处具有显着性。结果 与传统仪器相比，机器人组在针对中性对齐时表现出统计上更准确的结果 (p < 0.05) 和更少的异常值 (p < 0.05)。最终肢体对齐 (HKA) 的准确度为 0.8° ± 0.6° 与 2.0° ± 1.6°，3° 内的病例为 100% 与 75%，2° 内的病例为 93% 与 60%。对于机器人辅助膝关节，除股骨屈曲（1.3°±1.0°）外，骨切除角度精度低于0.6°，标准偏差低于0.4°，骨切除精度低于0.7 mm，标准偏差低于0.7 mm水平。结论 这项体外研究表明，与传统器械相比，这种新型 TKA 机器人系统可进行更准确、更可重复的骨切除术。它支持这种新机器人系统的临床使用。