Robotics in Total Knee Arthroplasty



Total knee arthroplasty (TKA) has become the standard procedure in the management of degenerative joint disease after conservative therapy options have been exhausted. However, despite conscientious planning and carefully performed procedures, surgeons are often unsatisfied with implant alignment. Various authors described significant axial or rotational malalignment, and mediolateral and ventrodorsal tilt.14 Seemingly small displacements of 2.5 mm potentially alter the range of motion by as much as 20°.5 None of the contemporary improvements in implant design and instrumentation has alleviated these problems.

This led to the development of various robotic systems for improved precision in surgery. Robots are able to accurately position and move tools, thereby reducing human error. These systems rely on preoperative imaging, registration, and planning. The first clinical use was reported 1985 in the field of neurosurgery.6 Orthopedic surgeons started using robotic devices around 1992 for total hip arthroplasty.7 The active surgical robot CASPAR® (Computer-Assisted Surgical Planning and Robotics) was adapted for total hip and knee arthroplasty and for anterior cruciate ligament repair.8 The first robot-assisted knee replacement with this system was performed in March of 2000 in the Orthopedic Center Kassel. A total of 108 consecutive cases were operated on at this institution and followed-up for at least 5 years in a prospective study.9


Total Knee Arthroplasty Robotic System Mechanical Axis Knee Society Score Fiducial Marker 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Vitos Orthopaedic Center KasselKasselGermany

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