Robotic-assisted total knee arthroplasty for post-traumatic osteoarthritis following tibial plateau fractures: A narrative review

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI:10.1016/j.jcot.2026.103375

F. Granata , F. Nasca , C.D. Cobisi , M.G.L. Bellia , C. Burgio , F. Bosco

{"title":"Robotic-assisted total knee arthroplasty for post-traumatic osteoarthritis following tibial plateau fractures: A narrative review","authors":"F. Granata , F. Nasca , C.D. Cobisi , M.G.L. Bellia , C. Burgio , F. Bosco","doi":"10.1016/j.jcot.2026.103375","DOIUrl":null,"url":null,"abstract":"<div><div>Post-traumatic osteoarthritis (PTOA) following tibial plateau fractures constitutes a demanding indication for total knee arthroplasty (TKA) because of residual deformities, altered joint biomechanics, soft-tissue imbalance, and the potential presence of retained hardware. Conventional TKA in this setting is associated with higher rates of intraoperative complications, suboptimal implant positioning, and increased revision risk. Robotic-assisted (RA) technologies have emerged as potential tools to enhance accuracy, restore alignment, and improve reproducibility in complex knee arthroplasty. The aim of this study is to summarize and critically appraise the current evidence on RA-TKA for PTOA after tibial plateau fractures, highlighting advantages, limitations, and future perspectives. A narrative review was conducted by searching PubMed and Scopus for clinical studies evaluating RA-TKA in the setting of prior tibial plateau fractures. Relevant case series, cohort studies, and comparative analyses were reviewed and synthesized. Preliminary evidence suggests that robotic-assisted TKA may improve the accuracy and reproducibility of component positioning; however, most quantitative accuracy data are derived from primary osteoarthritis cohorts, with limited PTOA-specific evidence currently available. Robotic platforms may also facilitate intraoperative soft-tissue balancing in anatomically distorted knees. However, available literature remains limited to small case series with heterogeneous patient cohorts and short follow-up durations. Functional outcomes and complication rates are inconsistently reported, and robust comparative data are lacking. RA TKA appears to be a promising approach for managing PTOA after tibial plateau fractures. Despite encouraging early results, current evidence is still preliminary. High-quality prospective studies, ideally multicenter with long-term follow-up, are required to substantiate the clinical, functional, and economic benefits of robotics in this challenging population.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"74 ","pages":"Article 103375"},"PeriodicalIF":0.0000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Orthopaedics and Trauma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0976566226000421","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/10 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Post-traumatic osteoarthritis (PTOA) following tibial plateau fractures constitutes a demanding indication for total knee arthroplasty (TKA) because of residual deformities, altered joint biomechanics, soft-tissue imbalance, and the potential presence of retained hardware. Conventional TKA in this setting is associated with higher rates of intraoperative complications, suboptimal implant positioning, and increased revision risk. Robotic-assisted (RA) technologies have emerged as potential tools to enhance accuracy, restore alignment, and improve reproducibility in complex knee arthroplasty. The aim of this study is to summarize and critically appraise the current evidence on RA-TKA for PTOA after tibial plateau fractures, highlighting advantages, limitations, and future perspectives. A narrative review was conducted by searching PubMed and Scopus for clinical studies evaluating RA-TKA in the setting of prior tibial plateau fractures. Relevant case series, cohort studies, and comparative analyses were reviewed and synthesized. Preliminary evidence suggests that robotic-assisted TKA may improve the accuracy and reproducibility of component positioning; however, most quantitative accuracy data are derived from primary osteoarthritis cohorts, with limited PTOA-specific evidence currently available. Robotic platforms may also facilitate intraoperative soft-tissue balancing in anatomically distorted knees. However, available literature remains limited to small case series with heterogeneous patient cohorts and short follow-up durations. Functional outcomes and complication rates are inconsistently reported, and robust comparative data are lacking. RA TKA appears to be a promising approach for managing PTOA after tibial plateau fractures. Despite encouraging early results, current evidence is still preliminary. High-quality prospective studies, ideally multicenter with long-term follow-up, are required to substantiate the clinical, functional, and economic benefits of robotics in this challenging population.

查看原文本刊更多论文

机器人辅助全膝关节置换术治疗胫骨平台骨折后创伤性骨关节炎：综述

胫骨平台骨折后的创伤性骨关节炎（PTOA）是全膝关节置换术（TKA）的一个重要适应症，因为它会导致残留的畸形、关节生物力学的改变、软组织的不平衡以及潜在的硬件残留。在这种情况下，传统TKA与术中并发症的发生率较高，植入物定位不理想，翻修风险增加有关。机器人辅助（RA）技术已成为复杂膝关节置换术中提高准确性、恢复对齐和提高可重复性的潜在工具。本研究的目的是总结和批判性评价目前关于RA-TKA治疗胫骨平台骨折后PTOA的证据，强调其优势、局限性和未来的展望。通过检索PubMed和Scopus，对评估RA-TKA治疗胫骨平台骨折的临床研究进行叙述性回顾。相关的病例系列，队列研究和比较分析进行了回顾和综合。初步证据表明，机器人辅助TKA可以提高部件定位的准确性和可重复性；然而，大多数定量准确性数据来自原发性骨关节炎队列，目前可获得的pta特异性证据有限。机器人平台也可以促进术中软组织平衡解剖扭曲的膝盖。然而，现有的文献仍然局限于具有异质患者队列和短随访时间的小病例系列。功能结果和并发症发生率的报道不一致，并且缺乏可靠的比较数据。胫骨平台骨折后，RA TKA似乎是一种很有前途的治疗PTOA的方法。尽管早期结果令人鼓舞，但目前的证据仍处于初步阶段。需要高质量的前瞻性研究，最好是多中心长期随访，以证实机器人技术在这一具有挑战性的人群中的临床、功能和经济效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.