Patient Outcomes Following Kinematic and Functional Alignment in Robotic-Assisted Total Knee Arthroplasty With Randomized Insert Types

This is a prospective interventional study evaluating outcomes in patients undergoing robotic-assisted total knee arthroplasty using the VELYS system. The study includes patients treated using either kinematic alignment or functional alignment techniques, which are determined by the operating surgeon based on clinical practice and are not randomized as part of the study protocol.

Within each alignment group, participants are randomized to receive one of two implant insert types: medial stabilised (MS) or cruciate retaining (CR). Randomisation is performed using a REDCap-based allocation system.

The primary objective of the study is to assess patient-reported outcomes following surgery. Secondary outcomes may include clinical and functional measures collected at predefined time points, including pre-operative and post-operative follow-up visits.

This study reflects real-world clinical practice while incorporating a randomized component for implant selection. The design allows for evaluation of both implant-related outcomes and comparisons across different alignment techniques, while maintaining clarity regarding which aspects of the intervention are randomized.

*Inclusion Criteria:*

• Patients undergoing robotic-assisted total knee arthroplasty using the VELYS system
• Diagnosis of knee osteoarthritis requiring surgical intervention
• Able to provide informed consent
• Willing to complete patient-reported outcome measures

**Exclusion Criteria:**

• Patients undergoing revision knee arthroplasty
• Presence of active infection
• Inability to comply with follow-up assessments
• Severe co-morbidities that may affect surgical outcomes or participation in the study