Gap Balancing Technique With Functional Alignment in Total Knee Arthroplasty Using the Cuvis Joint Robotic System: Surgical Technique and Functional Outcome

Introduction The application of robotic technologies in total knee arthroplasty (TKA) has widely grown in the past few years. The preoperative CT (computed tomography) scan planning of the knee along with the quantitative soft tissue information recorded and assessed by the robot can be utilized in achieving functional alignment and aid in gap balancing. Gap tension is an important factor influencing the clinical outcome after TKA. This paper describes our technique for gap balancing and functional alignment using a fully autonomous Cuvis joint robotic system. Methods A total of 624 knees underwent primary TKA using Cuvis robotic assistance in the time period between November 2023 to April 2024. A total of 360 patients that included 100 males and 260 females were included in the study. All the surgeries were performed by the same surgeon and the same posterior-stabilized (PS)-design prosthesis was implanted. The medial and lateral gaps were balanced using our technique intraoperatively. The patients were followed up at one, three, and six months duration postoperatively, and their knee functional outcomes were analyzed using the Oxford Knee Score (OKS). Results A total of 360 patients with a mean age of 64.36 were part of this study. The study shows significant improvement in knee function post surgery. The average preoperative OKS recorded was 15.82, which improved at the postoperative sixth-month follow-up to a mean value of 42.07. There were no patients with poor results as per OKS scores, and no patients required any revision procedures. Conclusion The gap balancing technique with functional knee alignment using the Cuvis joint robotic system improved short-term outcomes, with balanced gaps, controlled alignment, and preserved soft tissue tension. No complications were reported, but further long-term, multicenter studies are needed for definitive conclusions.