Total Knee Arthroplasty With Personalized Implantation: Computer Navigation-Assisted Surgery Versus Robotic-Assisted Surgery

Background and Rationale: Personalized alignment in total knee arthroplasty combines the restoration of the patient's unique anatomy (restricted kinematic alignment) with joint stability. While computer-assisted navigation has been successfully used since 2003 to plan and control implant positioning, robotic assistance is gaining popularity due to its ability to perform more precise bone cuts using a haptic robotic arm. This study seeks to investigate whether this technical gain in precision translates into a real clinical benefit for the patient in terms of satisfaction and joint perception. Study Design: This is an interventional, prospective, randomized, single-center study. A total of 140 patients (70 per group) will be enrolled. Interventions: Participants will be randomly assigned to one of the following two arms: Navigation Group: TKA implantation (Attune® CR) guided by an intraoperative computer navigation system. Robotic Group: TKA implantation using a robotic-arm-assisted system (a motorized saw linked to the navigation software). Follow-up and Evaluations: Patients will be followed for 24 months. Evaluations will include: Primary Endpoint: Forgotten Joint Score (FJS) at 3, 12, and 24 months. Secondary Endpoints: Satisfaction and functional scores (KOOS, SKV, Net Promoter Score), range of motion measurements, operative time, and monitoring of any complications. Target Population: Adults (≥ 18 years) scheduled for primary total knee arthroplasty for osteoarthritis, with no history of major bone surgery on the affected limb.