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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2025; 60(06): s00451814408
DOI: 10.1055/s-0045-1814408
Original Article

Results of Total Knee Arthroplasty with Robotic Assistance[*]

Resultados da artroplastia total do joelho com assistência robótica

Authors

  • Joao Paulo Fernandes Guerreiro 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil
    2   Hospital de Ortopedia Uniorte, Londrina, PR, Brazil

  • Julia Canassa Pinto 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil

  • Livia Schauff 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil

  • Tiago Delfino Pedrollo 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil

  • Paulo Roberto Bignardi 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil

  • Marcus Vinicius Danieli 

    1   Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil
    2   Hospital de Ortopedia Uniorte, Londrina, PR, Brazil

Financial Support The authors declare that they did not receive financial support from agencies in the public, private or non-profit sectors to conduct the present study.
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Abstract

Objective

To investigate the outcomes of total knee arthroplasty (TKA) when assisted by a robotic arm compared with the conventional approach.

Methods

We conducted a retrospective cohort study including 96 patients who underwent TKA, assigned to either the robotic-assisted (RA) group or a conventional technique (CT) groups. All surgeries were performed without the use of a tourniquet and included administration of intravenous tranexamic acid. Patients were matched based on sex, age, and preoperative hemoglobin (Hb) and hematocrit (Ht) values. Key outcomes evaluated were perioperative blood loss (assessed through changes in Hb and Ht), operative duration, length of hospital stay, and postoperative complications up to 6 months.

Results

There were 34 patients from each group successfully matched for analysis. There were no significant differences between the groups regarding Hb or Ht reduction (RA: Hb −2.27 ± 1.21 g/dL, Ht −6.56 ± 3.43%; vs. CT: Hb −2.00 ± 1.07 g/dL, Ht −5.85 ± 3.26%; p > 0.05). The mean surgical time was also similar (RA: 108.9 ± 20.8 vs. CT: 111.8 ± 26.2 min; p = 0.905). Notably, patients in the RA group experienced a shorter hospitalization period (median: 2 vs. 2.5 days; OR = 0.12; 95% CI = 0.03–0.57; p = 0.008). Incidence of postoperative complications within 6 months did not differ significantly between groups.

Conclusion

Robotic-assisted TKA was not associated with measurable improvements in blood loss, operative time, or postoperative complications. However, it contributed to a reduction in hospital stay compared with the conventional technique.

Resumo

Objetivo

Investigar os resultados da artroplastia total do joelho (ATJ) com assistência de braço robótico em comparação com a abordagem convencional.

Métodos

Realizamos um estudo de coorte retrospectivo, incluindo 96 pacientes submetidos a ATJ, que foram alocados aos grupos assistência robótica (AR) ou técnica convencional (TC). Todas as cirurgias foram realizadas sem o uso de torniquete e incluíram a administração de ácido tranexâmico intravenoso. Os pacientes foram pareados com base no sexo, na idade e nos valores pré-operatórios de hemoglobina (Hb) e hematócrito (Ht). Os principais desfechos avaliados foram a perda sanguínea perioperatória (avaliada por meio de alterações em Hb e Ht), a duração operatória, o tempo de internação hospitalar e as complicações pós-operatórias até em 6 meses.

Resultados

Foram 34 pacientes para cada grupo pareados com sucesso para análise. Não houve diferenças significativas entre os grupos quanto à redução de Hb ou Ht (AR: Hb −2,27 ± 1,21 g/dL, Ht −6,56 ± 3,43%; vs. TC: Hb −2,00 ± 1,07 g/dL, Ht −5,85 ± 3,26%; p > 0,05). O tempo cirúrgico médio também foi semelhante (AR: 108,9 ± 20,8 vs. TC: 111,8 ± 26,2 min; p = 0,905). Notavelmente, os pacientes do grupo AR tiveram um período de hospitalização mais curto (mediana: 2 vs. 2,5 dias; OR = 0,12; IC 95% = 0,03–0,57; p = 0,008). As complicações pós-operatórias em 6 meses não diferiram significativamente entre os grupos.

Conclusão

A ATJ com assistência robótica não foi associada a melhorias mensuráveis na perda sanguínea, tempo operatório ou complicações pós-operatórias. Entretanto, contribuiu para uma redução na permanência hospitalar em comparação com a técnica convencional.

Keywords

arthroplasty - blood loss, surgical - knee - robotic surgical procedures

Palavras-chave

artroplastia - joelho - perda sanguínea cirúrgica - procedimentos cirúrgicos robóticos

Data Availability

Data will be available upon request to the corresponding author.


Authors' Contributions

Each author contributed individually and significantly to the development of the article. JPFG: supervision, validation, visualization, writing - original draft, writing - review & editing, conceptualization, data curation, formal analysis, investigation, methodology, validation, and visualization; JCP: research incentive, validation and visualization, data curation; writing - original draft; writing - review & editing; LS: research incentive, validation and visualization, data curation; writing - original draft; writing - review & editing; TDP: research incentive, validation and visualization, data curation; writing - original draft; writing - review & editing. PRB: conceptualization, formal analysis, validation and visualization; MVD: conceptualization; research incentive, validation, writing - review & editing, and visualization.


* Work developed at Hospital de Ortopedia Uniorte, Londrina, Brazil.




Publication History

Received: 12 September 2025

Accepted: 20 October 2025

Article published online:
30 December 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Joao Paulo Fernandes Guerreiro, Julia Canassa Pinto, Livia Schauff, Tiago Delfino Pedrollo, Paulo Roberto Bignardi, Marcus Vinicius Danieli. Results of Total Knee Arthroplasty with Robotic Assistance[*] . Rev Bras Ortop (Sao Paulo) 2025; 60: s00451814408.
DOI: 10.1055/s-0045-1814408