2026, Number 3
<< Back Next >>
Acta Med 2026; 24 (3)
Difference in surgical time between conventional and robotic-assisted total knee arthroplasty in patients with primary gonarthrosis
Villalobos MJ, Moguel SI, Villalobos RA, Hernández MJ
Language: Spanish
References: 26
Page: 237-242
PDF size: 580.97 Kb.
ABSTRACT
Introduction: robotic-assisted total knee arthroplasty (TKA)
has been designed to improve surgical precision but concerns
exist about longer operative time compared to traditional
techniques.
Objective: to compare operative time between
robotic-assisted and traditional TKA in primary gonarthrosis.
Material and methods: this retrospective comparative study
included ninety-four adult patients undergoing unilateral primary
TKA for primary gonarthrosis from March 2023 to March 2025 at
a single center. All surgeries used the same implant (Triathlon,
Stryker), subvastus approach and surgical team. Patients were
grouped by technique: robotic-assisted (Mako, Stryker; n =
59) or manual (n = 35). Operative time was defined as time
from skin incision to wound closure. Group comparisons used
independent t-tests or Mann-Whitney U tests and multiple linear
regression adjusted for age, sex, BMI and Kellgren-Lawrence
grade.
Results: baseline characteristics were similar except
for age with the robotic group being younger. Unadjusted
analysis showed no significant difference in surgical time
between groups. Multivariable regression showed that robotic
assistance was not associated with longer operative time (β =
5.98 minutes; 95%CI: -4.73 to 16.68; p = 0.27) after adjusting
for covariates. No covariate independently predicted surgical
time.
Conclusions: robotic-assisted TKA was not associated
REFERENCES
Patel NG, Waterson HB, Phillips JRA, Toms AD. 50 years of total kneearthroplasty. Bone Jt 360. 2019; 8 (3): 3-7.
Gao J, Xing D, Dong S, Lin J. The primary total knee arthroplasty: aglobal analysis. J Orthop Surg. 2020; 15 (1): 190.
Chaudhary C, Kothari U, Shah S, Pancholi D. Functional and clinicaloutcomes of total knee arthroplasty: a prospective study. Cureus.2024; 16 (1): e52415.
Minoda Y. Alignment techniques in total knee arthroplasty. J Jt SurgRes. 2023; 1 (1): 108-116.
Pérez García CK, Romero CEA, Santiago Esquivel LA, Carrillo SánchezAM, Cortés Cerda R. Asociación entre el dolor anterior postquirúrgicoy la reproducción inadecuada de la línea articular postquirúrgica enartroplastia primaria de rodilla. Acta Méd Grupo Ángeles. 2021; 19(1): 57-60.
Clapp IM, Braathen DL, Blackburn BE, Archibeck MJ, Peters CL.Robotic-assisted primary total knee arthroplasty requires fewersoft-tissue releases and is associated with a larger reduction in earlypostoperative pain. J Arthroplasty. 2025; 40 (7S1): S123-S129.
Fu X, She Y, Jin G, Liu C, Liu Z, Li W et al. Comparison of roboticassistedtotal knee arthroplasty: an updated systematic review andmeta-analysis. J Robot Surg. 2024; 18 (1): 292.
Inabathula A, Semerdzhiev DI, Srinivasan A, Amirouche F, Puri L,Piponov H. Robots on the stage: a snapshot of the American RoboticTotal Knee Arthroplasty Market. JB JS Open Access. 2024; 9 (3):e24.00063. doi: 10.2106/JBJS.OA.24.00063.
Wang G, Chen L, Luo F, Luo J, Xu J. Superiority of kinematic alignmentover mechanical alignment in total knee arthroplasty during mediumtolong-term follow-up: A meta-analysis and trial sequential analysis.Knee Surg Sports Traumatol Arthrosc. 2024; 32 (5): 1240-1252.
Kreuzer S, Brar A, Campanelli V. Dimensional accuracy of TKA cutsurfaces with an active robotic system. Comput Assist Surg (Abingdon).2022; 27 (1): 41-49.
Tandogan RN, Kort NP, Ercin E, Van Rooij F, Nover L, Saffarini M etal. Computer-assisted surgery and patient-specific instrumentationimprove the accuracy of tibial baseplate rotation in total kneearthroplasty compared to conventional instrumentation: a systematicreview and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;30 (8): 2654-2665.
Lee HJ, Park KK, Park YB, Choi SW, Kim BO, Kim SH. Accuracy ofadvanced active robot for total knee arthroplasty: a cadaveric study.J Knee Surg. 2024; 37 (2): 135-141.
Seidenstein A, Birmingham M, Foran J, Ogden S. Better accuracyand reproducibility of a new robotically-assisted system for totalknee arthroplasty compared to conventional instrumentation: acadaveric study. Knee Surg Sports Traumatol Arthrosc. 2021; 29(3): 859-866.
Hua Y, Salcedo J. Cost-effectiveness analysis of robotic-arm assistedtotal knee arthroplasty. PloS One. 2022; 17 (11): e0277980.
Londhe SB, Shetty S, Shetty V, Desouza C, Banka P, Antao N.Comparison of time taken in conventional versus active roboticassistedtotal knee arthroplasty. Clin Orthop Surg. 2024; 16 (2):259-264.
Londhe SB, Rudraraju RT, Shah RV, DeSouza C, Shetty V, Khan FS etal. Analysis of robot-specific operative time and surgical team anxietylevel and its effect on alignment during robot-assisted TKA. J RobotSurg. 2024; 18 (1): 86.
Palestino-Lara M, Rosenthal-Pereztman J, Valles-Figueroa JF,Rodríguez-Reséndiz F, Olguín-Rodríguez M, Zapata-Rivera S.Artroplastía total de rodilla navegada: una técnica quirúrgicaalternativa para pacientes con gonartrosis en México. Acta OrtopMex. 2024; 38 (4): 267-272.
Anis HK, Sodhi N, Klika AK, Mont MA, Barsoum WK, Higuera CA etal. Is operative time a predictor for post-operative infection in primarytotal knee arthroplasty? J Arthroplasty. 2019; 34 (7): S331-S336.
Acuña AJ, Samuel LT, Karnuta JM, Sultan AA, Swiergosz AM, KamathAF. What factors influence operative time in total knee arthroplasty?A 10-year analysis in a national sample. J Arthroplasty. 2020; 35 (3):621-627.
Hernandez AJ, De Almeida AM, Fávaro E, Sguizzato GT. The influenceof tourniquet use and operative time on the incidence of deep veinthrombosis in total knee arthroplasty. Clinics. 2012; 67 (9): 1053-1057.
Sodhi N, Khlopas A, Piuzzi N, Sultan A, Marchand R, Malkani A etal. The learning curve associated with robotic total knee arthroplasty.J Knee Surg. 2018; 31 (1): 17-21.
Sarrel K, Hameed D, Dubin J, Mont MA, Jacofsky DJ, CoppolecchiaAB. Understanding economic analysis and cost–effectiveness of CTscan-guided, 3-dimensional, robotic-arm assisted lower extremityarthroplasty: a systematic review. J Comp Eff Res. 2024; 13 (4):e230040.
Kayani B, Fontalis A, Haddad IC, Donovan C, Rajput V, HaddadFS. Robotic-arm assisted total knee arthroplasty is associated withcomparable functional outcomes but improved forgotten joint scorescompared with conventional manual total knee arthroplasty at fiveyearfollow-up. Knee Surg Sports Traumatol Arthrosc. 2023; 31 (12):5453-5462.
Zhang J, Ndou WS, Ng N, Gaston P, Simpson PM, Macpherson GJet al. Robotic-arm assisted total knee arthroplasty is associated withimproved accuracy and patient reported outcomes: a systematicreview and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022;
Hernández-Vaquero D. Navegación asistida por ordenador versuscirugía convencional en artroplastía total de rodilla. Una revisiónnarrativa de la literatura. Acta Ortop Mex. 2024; 38 (5): 321-332.