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Purpose <p>This study investigated the clinical outcomes of robotic-assisted unicompartmental knee arthroplasty (UKA) performed using a surface-matching kinematic technique that restores native joint morphology without alignment constraints. The primary aim was to determine the incidence and distribution of radiolucent lines (RLLs), and the secondary aim was to evaluate short-term revision rates and clinical outcomes.</p> Methods <p>This retrospective cohort study reviewed 242 medial UKAs performed between November 2021 and August 2023 by the same high‑volume surgeon using a surface‑matching technique. Radiographic parameters and patient‑reported outcome measures (PROMs) obtained before and 1 year after surgery were assessed, with radiographic evaluation performed independently of the clinical outcome assessment. A cemented JOURNEY II Uni implant was used in all cases, with intraoperative surface mapping used to guide kinematic placement of components without alignment constraints.</p> Results <p>RLLs were seen in 21.9% of knees, exclusively on the tibial side and mainly in the most medial (zone 1: 14.8%, 95% confidence interval [CI] 10.9–19.9) and posterior regions (zone 9: 15.3%, 95% CI 11.3–20.3). A larger tibial component was the only independent predictor of RLLs (odds ratio 1.54, 95% CI 1.27–1.88; <i>p</i> = 0.04). All PROMs improved, with no differences between knees with and without RLLs. No revisions, infections, or major complications occurred during the short‑term (1‑year) follow‑up.</p> Conclusions <p>In kinematically aligned UKA performed with a surface‑matching technique without restricting tibial varus or posterior slope, RLLs appeared in 21.9% of cases and were concentrated medially on the anteroposterior view and posteriorly on the lateral view. Tibial component size was the only independent risk factor. Short‑term clinical outcomes improved similarly regardless of RLL presence.</p> Level of evidence <p>Level IV.</p>

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Radiolucent lines after robotic-assisted surface-matching kinematically aligned UKA: short-term incidence and lack of association with tibial alignment

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  • 发表日期：

    2026年5月20日

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  • Junya Itou,
  • Ayano Kuwasawa,
  • Kotaro Nihei,
  • Ken Okazaki

摘要

Purpose

This study investigated the clinical outcomes of robotic-assisted unicompartmental knee arthroplasty (UKA) performed using a surface-matching kinematic technique that restores native joint morphology without alignment constraints. The primary aim was to determine the incidence and distribution of radiolucent lines (RLLs), and the secondary aim was to evaluate short-term revision rates and clinical outcomes.

Methods

This retrospective cohort study reviewed 242 medial UKAs performed between November 2021 and August 2023 by the same high‑volume surgeon using a surface‑matching technique. Radiographic parameters and patient‑reported outcome measures (PROMs) obtained before and 1 year after surgery were assessed, with radiographic evaluation performed independently of the clinical outcome assessment. A cemented JOURNEY II Uni implant was used in all cases, with intraoperative surface mapping used to guide kinematic placement of components without alignment constraints.

Results

RLLs were seen in 21.9% of knees, exclusively on the tibial side and mainly in the most medial (zone 1: 14.8%, 95% confidence interval [CI] 10.9–19.9) and posterior regions (zone 9: 15.3%, 95% CI 11.3–20.3). A larger tibial component was the only independent predictor of RLLs (odds ratio 1.54, 95% CI 1.27–1.88; p = 0.04). All PROMs improved, with no differences between knees with and without RLLs. No revisions, infections, or major complications occurred during the short‑term (1‑year) follow‑up.

Conclusions

In kinematically aligned UKA performed with a surface‑matching technique without restricting tibial varus or posterior slope, RLLs appeared in 21.9% of cases and were concentrated medially on the anteroposterior view and posteriorly on the lateral view. Tibial component size was the only independent risk factor. Short‑term clinical outcomes improved similarly regardless of RLL presence.

Level of evidence

Level IV.