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Purpose <p>This study quantifies the reproducibility of soft tissue laxity and gap measurements under manual stress, and implant positioning planning using the imageless ROSA<sup>®</sup> robotic system, by comparing a senior high-volume surgeon with a low-volume resident.</p> Methods <p>In this single-centre prospective study, 17 patients undergoing robotic-assisted total knee arthroplasty were evaluated. Intra- and inter-operator variability was assessed by recording intraoperative measurements and planning outcomes using a standardized protocol for functional alignment (FA).</p> Results <p>Both intra and inter-operator analyses demonstrated good to excellent reproducibility (ICC &gt; 0.75–0.9) for soft tissue and gap assessments. Minor variability was observed in planning parameters (ICC &lt; 0.60), specifically stylus height, femoral flexion, and distal femoral resection, likely reflecting subjective adjustments by the high-volume surgeon.</p> Conclusion <p>High reproducibility in soft tissue measurements and surgical planning across surgeons with different experience levels is shown by the ROSA<sup>®</sup> robotic system, while flexibility for individualized surgical strategies is retained.</p>

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Inter- and intra-operator variability in ligament balance measurements in total knee arthroplasty with the robotic navigation system (ROSA®): in vivo study

  • 期刊论文

  • 发表日期：

    2025年11月10日

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  • Johnatan Everaert,
  • Esfandiar Chahidi,
  • Maarten Ulrix,
  • Arnaud Delafontaine,
  • Erwan Eggermont,
  • Jean-François Fils,
  • Raphael Janssens,
  • Arnaud Clavé,
  • Jacques Hernigou,
  • Bruno Baillon

摘要

Purpose

This study quantifies the reproducibility of soft tissue laxity and gap measurements under manual stress, and implant positioning planning using the imageless ROSA® robotic system, by comparing a senior high-volume surgeon with a low-volume resident.

Methods

In this single-centre prospective study, 17 patients undergoing robotic-assisted total knee arthroplasty were evaluated. Intra- and inter-operator variability was assessed by recording intraoperative measurements and planning outcomes using a standardized protocol for functional alignment (FA).

Results

Both intra and inter-operator analyses demonstrated good to excellent reproducibility (ICC > 0.75–0.9) for soft tissue and gap assessments. Minor variability was observed in planning parameters (ICC < 0.60), specifically stylus height, femoral flexion, and distal femoral resection, likely reflecting subjective adjustments by the high-volume surgeon.

Conclusion

High reproducibility in soft tissue measurements and surgical planning across surgeons with different experience levels is shown by the ROSA® robotic system, while flexibility for individualized surgical strategies is retained.