Study Summary

Ninety-six patients with grade 3–4 knee osteoarthritis (KOA) were randomized to receive mechanical alignment or restrictive kinematic alignment during robotic-assisted total knee arthroplasty (TKA). The primary outcome of interest was the Oxford Knee Score. Other outcomes included Visual Analog Scale (VAS) pain, range of motion (ROM), Knee Society Score (KSS), the 36-Item Short Form Health Survey (SF-36), and Forgotten Joint Score-12 (FJS-12). Outcomes were assessed at 14 days, 3, 6, and 12 months postoperatively. Overall, the results of the study revealed that restrictive kinematic alignment resulted in significantly lower early postoperative pain and improved early ROM, as well as higher FJS-12 at 12 months. Functional outcomes at one year were otherwise comparable between groups. These findings suggest that restrictive kinematic alignment may enhance early recovery without compromising longer-term outcomes.