Journal of Clinical Medicine
Mediolateral Joint Balance Assessment Is Reproducible Between Surgeons, Under No Standardized Varus–Valgus Stress, During Robot-Assisted Total Knee Arthroplasty
By Graciela Grillo, Alexandre Coelho, David Martí and 4 others.
Abstract
Objective
To evaluate inter-surgeon variability in mediolateral joint balance assessment during robotic-assisted total knee arthroplasty (TKA) using the robotic surgical assistant (ROSA) Knee System, and to determine whether such variability influences the surgical planning generated by this system.
Methods
An observational study was conducted including 101 patients undergoing primary robotic-assisted TKA. Two experienced surgeons independently assessed intraoperative mediolateral laxity by manually applying varus–valgus stress across six predefined flexion angles (0°, 30°, 45°, 60°, 90°, and 120°). Measurements of medial and lateral gaps (mm) and varus–valgus alignment (°) were recorded using the ROSA Knee System. Inter-observer differences were analysed using the Wilcoxon signed-rank test, and reliability was assessed using the intraclass correlation coefficient (ICC). The impact of inter-surgeon variability on surgical planning, including bone resection and compartmental space measurement parameters, was also evaluated.