Abstract / Summary
Abstract Objective To compare the clinical and radiographic outcomes of robotic-assisted total knee arthroplasty (r-TKA) with those of sensor-guided total knee arthroplasty (s-TKA) in patients with severe varus or valgus deformities. Methods This retrospective study enrolled 76 patients with symptomatic knee arthritis with severe varus or valgus deformity, who were assigned to undergo r-TKA ( n = 38) or s-TKA ( n = 38) between May 2024 and May 2025. Radiological parameters included the lateral femoral component (LFC) angle, lateral tibial component (LTC) angle, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, and hip–knee–ankle (HKA) angle. Data on operative time, visible blood loss volume (VBL), flexion range when walking (FRW), straight-leg raise (SLR) and complications were extracted from patient records. Visual analogue scale at rest and in motion (rVAS, mVAS) scores, passive and active range of motion (pROM, aROM), Western Ontario and McMaster Universities Arthritis Index (WOMAC [stiffness, pain, and function]) scores and Knee Society Score (KSS) were recorded at 1, 3, and 12-months postoperatively. Results The r-TKA group has demonstrated significantly smaller absolute deviations from the target for both HKA and LTC angles, and a higher proportion of knees achieving alignment within ± 3° of the target ( p < 0.05). While no significant intergroup difference was observed in WOMAC stiffness score or pROM, the r-TKA group has demonstrated significantly better aROM and FRW throughout the trial ( p < 0.05). At 3-month and 1-year follow-up, the r-TKA group has shown higher KSS and WOMAC function scores, respectively, than the s-TKA group ( p < 0.05). Postoperatively, no patients in either group required manipulation under anaesthesia (MUA). At 1 year, complication rates and revision-free status were comparable between the groups, with no revisions performed in either group. Conclusion Both techniques have yielded satisfactory short-term outcomes in knees with severe varus or valgus deformities. Compared with s-TKA, r-TKA has provided more precise coronal alignment of lower-limb and superior sagittal component positioning; as well as better functional recovery, as reflected by KSS, WOMAC function score, aROM, FRW and SLR. GRADE evidence level Low.