2026 AAHKS Annual Meeting: Functionally Aligned Vs. Mechanically Aligned Robotic TKA: A Double-Blinded Randomized Trial

100 patients undergoing primary robotic-assisted total knee arthroplasty (TKA) were randomized to receive functional alignment (FA) (n=50) or mechanical alignment (MA) (n=50). The primary outcomes of interest were patient-reported knee function, pain, and joint awareness, assessed using the Oxford Knee Score (OKS), Forgotten Joint Score (FJS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and other validated measures. Secondary outcomes included surgical time, length of stay, physiotherapy sessions, and opioid consumption. Outcomes were assessed at 6 weeks, 6 months, 1 year, and 2 years. Overall, the results revealed that FA resulted in significantly better FJS and WOMAC outcomes at 1 and 2 years compared to MA, although early recovery and most perioperative outcomes were similar. These findings suggested that FA may provide modest improvements in longer-term patient-reported outcomes without compromising perioperative recovery.