Robotic-Arm Assisted vs Manual Total Knee Arthroplasty: A Comparative Analysis of Pre and Post-operative Gait and Posture in a Case-Control Study

Background. Few studies assess gait in robotically assisted total knee arthroplasty (raTKA); none in ROSA raTKA patients. Methods Maximum voluntary isometric strength (MVIS), body centre-of-mass (COM) walking kinematics, body-weight distribution, time-up-and-go (TUG) test, quality of life, and range of motion (ROM) were evaluated in three postoperative months between manually TKA (mTKA) and raTKAs. A surgeon performed all procedures using the same technique. Results Forty-six uncomplicated primary raTKAs and 24 mTKAs were included, showing similar demographics, grip strength, and preoperative KOOS scores. At three months, there were no significant differences in quadriceps (p = 0.869), tibialis MVIS (p = 0.327), COM kinematics (p = 0.801), body-weight distribution (p = 0.189), TUG (p = 0.59), and ROM (p = 0.165). Patient satisfaction was significantly higher in the raTKA group (p = 0,048) and furthermore numerical differences favoring the raTKA group were observed in tibialis anterior MVIS, weight distribution, TUG, and ROM, even though there were no statistically significant differences. Conclusions At three months post-operation, ROSA raTKA resulted in significantly higher patient satisfaction but did not yield statistically differences in gait, posture, or strength outcomes compared to mTKA. The observed non-significant numerical differences in favor of the raTKA grpoup, should be explored in larger, long-term, randomized controlled trials.