Functional alignment of knee valgus deformity in robot-assisted knee replacement: modern aspects and prospects

The authors analyze effectiveness of functional alignment in robot-assisted knee arthroplasty in patients with valgus deformity. The study demonstrates a significant improvement in clinical indicators: KSS score increase from 69.5 to 95 in the knee and from 65 to 94 in functional components, median OKS score 45 and high FJS score (93). Radiological assessment confirmed effective correction of valgus deformity: the HKA angle was corrected from 187° to 181.1°, valgus deformity decreased from 3° to 1°. Functional alignment demonstrated significant advantages compared to mechanical and modified kinematic approaches: significant less need for additional soft tissue release (15.7% versus 35.7-38.6%), better joint balance in extension (99.0% versus 86.0%) and flexion (98.0% versus 43.0%). Range of motions improved (flexion contracture decrease from preoperative 0-15° to postoperative 0-5° while maintaining flexion range at 130°). Technological advantages of robot-assisted technique include better control of implantation parameters: valgus angle of femoral component (on average 1.5°), external rotation of femoral component (0°) and tilt of tibial component (0.1°). The CPAK classification provided a personalized approach to deformity correction, taking into account individual anatomical features. Long-term analysis revealed low complication rate (1.7% of aseptic loosening cases) and efficacy of functional approach in robotic-assisted knee arthroplasty for valgus deformity.