2026 SICOT Annual Meeting: 2-year results of robotic-assisted functionally aligned vs. conventional mechanically aligned total knee arthroplasty – A randomized controlled trial

209 patients undergoing cemented bi-cruciate stabilized total knee arthroplasty (TKA) were randomized to robotic-assisted functionally aligned TKA using the hand-held NAVIO system or conventional TKA; initial allocation by group was not reported. At 24 months, 191 patients were available for analysis (robotic: n=94; conventional: n=97). The primary outcome of interest was clinical response according to Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) criteria using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes included Knee Society Score (KSS), Forgotten Joint Score (FJS), Visual Analogue Scale (VAS) pain, EuroQol-5 Dimensions (EQ-5D), objective functional tests, and radiographic alignment. Outcomes were assessed at 24 months. Overall, responder status and patient-reported and objective clinical outcomes were similar between groups, although robotic TKA resulted in greater femoral component flexion and posterior tibial slope. These findings suggest that robotic-assisted functional alignment altered component positioning but did not provide superior clinical outcomes at 2 years.