Individualized alignment and ligament balancing technique with the ROSA® robotic system for total knee arthroplasty

Purpose: Higher patient's expectations and dissatisfaction following total knee arthroplasty are well-documented phenomena. Despite the implications of different patients' related factors both modifiable and nonmodifiable, in the last decade a lot of emphasis has been focused on surgical technique, implant alignment and stability both as a cause and a potential solution of several problems. Methods: Different alignment and balancing techniques have been recently described and the introduction of new technologies such as computer and robotic-assisted surgery have been the basis for their optimization. In this paper, the surgical technique of the ROSA Knee System will be described focusing on the potential alignment options and the ligament balancing technique. The current literature available about the system will also be analyzed. Results: The ROSA® robotic system have been recently introduced in the market and presents specific and peculiar features to optimize ligament balancing and an individualized alignment of the implant in a three dimensional prospective. Discussion: The system is showing a favourable gap balancing technique and the possibility to create an individualized alignment. Preliminary results have now been shown in the literature both on the accuracy of the system and on clinical outcomes. Conclusions: Preliminary results are promising both in terms of accuracy of the system and of clinical outcomes.