Optimizing unicompartmental knee arthroplasty with robotic-assisted surgery ensures precision, personalisation and faster recovery.
This blog article is based on the presentation titled “Optimizing Unicompartmental Knee Arthroplasty with Robotic-Assisted Surgery” led by Professor Etienne Cavaignac (CHU Toulouse). It outlines how robotics are transforming surgical practices, improving accuracy and patient outcomes in partial knee replacement procedures.
Robotic-assisted knee surgery: improved accuracy and control
Robotic-assisted knee surgery allows unparalleled control and reproducibility throughout unicompartmental knee arthroplasty (UKA). Traditional UKA procedures are technically demanding and historically underused, despite proven advantages over total knee arthroplasty (TKA). The robotic system employed by Professor Cavaignac provides real-time intraoperative feedback, enabling precision milling, smart mapping and intraoperative gap assessment.
These enhancements significantly reduce implant malpositioning, a known factor in revision risk. Studies referenced in Prof. Cavaignac’s work confirm that robotic systems like CORI™ improve surgical accuracy and functional outcomes, leading to better patient-reported outcome measures (PROMs) and implant survivorship.
Partial vs. total knee arthroplasty: functional and recovery benefits
When clinically indicated, unicompartmental knee arthroplasty offers substantial benefits over total knee replacement:
- Faster recovery: UKA is less invasive, resulting in lower morbidity, less postoperative pain and shorter hospital stays.
- Improved joint function: The procedure preserves more of the knee’s natural kinematics, which supports better proprioception and balance.
- Higher patient satisfaction: Clinical data presented by Prof. Cavaignac reveal superior outcomes in Forgotten Joint Scores and Knee Society Scores (KSS) compared to TKA.
These benefits are amplified when robotic-assisted systems are used, ensuring that only the diseased compartment is addressed, and preserving healthy bone and ligaments.
True personalisation in knee implant surgery
One of the central themes in Prof. Cavaignac’s presentation is the importance of true personalisation. This goes beyond selecting implant sizes: it involves tailoring the surgical plan to the individual anatomy and ligamentous structures of each patient.
Morphometric analysis of the patient’s knee
Before or during surgery, the robotic system performs a morphometric assessment of the patient’s knee. This involves analysing the precise dimensions and contours of the femur, tibia and joint surfaces without the need for preoperative CT or MRI imaging. This real-time mapping provides an accurate understanding of the patient’s native anatomy, rather than relying on average population data, and forms the basis for tailoring implant size and placement accordingly.
Real-time adaptation of implant positioning
During the procedure, the robot allows the surgeon to adjust the positioning of the implant with millimetric precision based on the individual’s joint shape and mechanical axis. Unlike manual techniques where adjustments may rely on the surgeon’s estimation, robotic systems guide implant placement in a reproducible way. This ensures optimal alignment and load distribution, both of which are key for implant longevity and functional performance.
Intraoperative measurement of ligament tension
An often overlooked, yet critical, factor in knee arthroplasty is soft tissue balance. With robotic assistance, the surgeon can measure ligament tension in real time throughout the range of motion. This data helps avoid overstuffing or instability by confirming that the implant will function harmoniously with the preserved ligaments. Balancing the joint with precision not only improves knee kinematics but also reduces the risk of pain or dysfunction postoperatively.
This approach is especially valuable in patients with anatomical variability or in populations where standardised implants may not be optimal (e.g., noted sexual dimorphism in certain demographics).
Efficiency and predictability through robotics
Robotic-assisted surgery introduces a new standard of efficiency in UKA. Prof. Cavaignac highlights several features contributing to this:
- Portable systems requiring minimal installation.
- Image-free mapping: Unlike CT-based planning, these systems use real-time mapping to reduce preoperative imaging and radiation exposure.
- Surgical clarity and reproducibility: Surgeons are equipped with reliable tools to perform consistently high-quality procedures, reducing variability due to fatigue or human error.
Moreover, the integration of robotics enables a smoother workflow from planning to post-operative evaluation, creating an efficient and standardised pathway for patients undergoing UKA.
Conclusion & Findings
Unicompartmental knee arthroplasty, when performed with robotic assistance, is no longer a marginal option but a viable, often superior, alternative to total knee replacement in selected cases. With improved surgical accuracy, patient-specific personalisation and faster recovery, this method delivers on the promise of modern orthopaedics.
To learn more about robotic surgical innovations and evidence-based approaches in knee surgery, we invite you to explore other studies by Professor Cavaignac.
For high-level care grounded in the latest technological advancements, trust Professor Cavaignac and his team for your knee surgery journey.