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Osteoarthritis, KneeNCT07201207

Robotic-assisted (MAKO) Versus Manual Total Knee Arthroplasty for Knee Osteoarthritis

A study testing Robotic-assisted total knee arthroplasty and Manual total knee arthroplasty in people with Osteoarthritis, Knee, run by Satakunta Central Hospital.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Background: Total knee arthroplasty is a golden standard procedure for end-stage knee osteoarthritis. However, up to 20% of the patients are not satisfied with the outcome. Recently, robotic-assisted TKAs have been developed to offer individual alignment and to achieve accuracy in positioning with more subtle… Read more about this study

Who is it for?
Ages 50 to 80 years
Conditions the study is for
Osteoarthritis, Knee
What is being tested?
Robotic-assisted total knee arthroplasty and Manual total knee arthroplasty
Could I receive a placebo?
No, everyone receives an active treatment
How many people
170 participants
Where
No sites listed yet
Study dates
Sep 2025to Sep 2037
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age over 50 and below 80 years
  • End-stage Kellgren-Lawrence grade IV KOA
  • Failed conservative treatment

Who cannot join

  • Post-traumatic knee osteoarthritis
  • Rheumatoid arthritis
  • Previous knee infections
  • Previous knee surgery (other than diagnostic arthroscopy or meniscectomy)
  • Knee range of motion within 15 to 100 degrees
  • Mechanical axis over 15 degrees of varus or over 10 degrees of valgus
Show all 13Show fewer
  • Body mass index over 40 kg/m2
  • Significant patellofemoral osteoarthritis (Kellgren-Lawrence grade III or IV)
  • Diabetes treated with insulin
  • Malignancy with ongoing treatment
  • Systemic glukocorticosteroid or antimetabolite medication during the last 5 years
  • Conditions that do not allow general anesthesia
  • Patients' denial for operative treatment and/or participation in the trial

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Juha Kukkonen, dos MD contact

+358 45 177 7747

juha.kukkonen@sata.fi

Aleksi Annaniemi, PhD MD contact

+358 505117060

aleksi.annaniemi@sata.fi

About this study

Official title: Single-center, Randomized, Controlled, Double Blinded, 24-month Trial to Compare Robotic-assisted (MAKO) and Manual Total Knee Arthroplasty for Primary Osteoarthritis With 10 Year Follow-up for Complications

Background: Total knee arthroplasty is a golden standard procedure for end-stage knee osteoarthritis. However, up to 20% of the patients are not satisfied with the outcome. Recently, robotic-assisted TKAs have been developed to offer individual alignment and to achieve accuracy in positioning with more subtle soft-tissue handling, thus possibly leading into better outcome.

Hypothesis: The investigators hypnotize that, robotic-assisted TKA is superior to manual TKA for end-stage osteoarthritis in respect to functional outcome, short-term rehabilitation and cost-efficiency.

Read more

Trial desing: The investigators will conduct a single-center, randomized, controlled, double blinded superiority trial of 24-months to compare robotic-assisted and manual total knee arthroplasty in respect to functional outcome, implant positioning, short-term rehabilitation and cost-efficiency with up to 10 years follow-up for complications.

The principle outcome measure will be patient reported outcome measure (PROM) Oxford knee score (OKS) points (0-48 points) at two years after surgery. Minimal clinically important difference will be considered as 5 points. Other PROMS, patient satisfaction, short-term rehabilitation, implant positioning, knee range of motion, length of sick leave and cost efficiency will also be reported. Patients will be followed up to 10 years for complications (infection, manipulation and revisions).

This study will be conducted in Central Hospital of Satakunta (Satasairaala), Finland. The investigators will recruit 170 adult patients (aged 50-80), with end-stage (Kellgren-Lawrence grade IV) primary osteoarhritis. Patients will be randomly assingned to either robotic-assisted or manual TKA. Patients will be blinded by the intervention method used. Personnel and investigators assessing the patients and interpreting the data will also be blinded to the surgical method.

Being tested
Robotic-assisted total knee arthroplasty, Manual total knee arthroplasty
Keywords
arthroplasty, robotic-assisted arthroplasty, knee osteoarthritis
Medical subject headings
Osteoarthritis, Knee

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Robotic-assisted total knee arthroplastyDevice

    In robotic-assisted total knee arthroplasty, the procedure is performed with the guidance of the robot according to CT-based plan.

  • Manual total knee arthroplastyProcedure or surgery

    Also called Traditional total knee arthroplasty, Jig-guided total knee arthroplasty

    In manual total knee arthroplasty, the procedure is performed with jig guides according to whole leg weight bearing x-ray planning.

Study groups in NCT07201207
Study groupRoleWhat they receive
Robotic-assisted total knee arthroplastyExperimentalThe intervention group will undergo MAKO assisted RATKA. The patients will have individualized alignment. Knee balance is achieved with bony cuts and implant positioning, to avoid soft tissue releases. A preoperative planning based on computed tomography (CT) scans is made and intraoperatively computer assisted gap balancing is performed based on the plan and patient's soft tissue envelope and native joint line. The precise pre-operative planning, balancing and alignment method has been described by Calliess T el al.
Receives: Device: Robotic-assisted total knee arthroplasty
Manual total knee arthroplastyActive comparatorThe control group will undergo manual jig-guided TKA, with bony cuts made to achieve neutral mechanical axis, and if necessary, knee balancing will be performed by soft tissue releases. Weight bearing semi-flexion radiographs and long leg radiographs are used for preoperative planning. Intramedullary guiding rod is used in femur to align the cuts in 6 to 7 degrees of valgus. Femoral component rotation is fixed to trans-epicondylar line. Tibia cuts are aligned with either intra- or extramedullary guiding rod according to the preference of the surgeon. Tibia component rotation is fixed to medial one-third of tibial tubercle. After bony cuts, knee balancing is performed with soft-tissue and ligament releases if necessary.
Receives: Procedure: Manual total knee arthroplasty

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Oxford Knee score OKS at 24 months

    Patient reported outcome measure, knee function questionnaire Oxford Knee Score (OKS) at 24 month. Scale from 0 (=worst) to 48 (=excellent) points Minimal clinically important difference considered as 5 points.

    Measured: 24 month

Secondary outcomes (27)
  1. Oxford Knee Score at 3 and 12 months

    Patient reported outcome measure, knee function questionnaire Oxford Knee Score (OKS) at 3 and 12 months. Scale from 0 (=worst) to 48 (=excellent) points. Minimal clinically important difference considered as 5 points.

    Measured: 3 and 12 months visits

  2. Knee injury and Osteoarthritis Outcome Score (KOOS) at 3, 12 and 24 months

    Patient reported outcome measure, knee function questionnaire KOOS points at 3, 12 and 24 months after the operation. Scale from 0 (=worst) to 100 (=excellent).

    Measured: 3, 12 and 24 months

  3. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) at 3, 12 and 24 months.

    Patient reported outcome measure, knee function questionnaire WOMAC score at 3, 12 and 24 months after the operation. Scale from 0 (= excellent) to 96 (= worst) points.

    Measured: 3, 12 and 24 months

  4. Patient satisfaction inquiry at 3, 12 and 24 months

    Patient satisfaction question asked at 3, 12 and 24 months after the operation: If you could choose again, would you still go for the sugery? 0= no 1 = probably not 2= I don't know 4 = probably yes 5 = yes.

    Measured: 3, 12 and 24 months

  5. Working ability, lenght of the sick leave

    Length of the sick leave after the surgery, measured as days. Asked from the patient and checked from the patient files.

    Measured: up to 24 months

  6. Working ability, part-time vs full-time

    Asked from the patient at the 3, 12 and 24 months follow-ups visits. Has the operation changed your ability to work full-time or part-time? Options: a) yes my work changed from full-time to part-time after surgery b) no my work is as much full-time or part-time as it was before the surgey c) yes my work changed from full-time to part-time after surgery d) my work as part-time or full-time has changed from other reasons not related to the knee.

    Measured: Asked at 3 month, 12 months and 24 months after the surgery

  7. Working ability, physical demands of the job

    Asked from the patient at the 3, 12 and 24 months follow-ups visits. Has the physical demands of your job changed after the operation because of the knee? Options: a) yes the physical demands of my job is now lower than it was before the surgery b) no my work is as physically demanding as it was before the surgery c) yes the physical demands of my job is now higher than it was before the surgery d) the physical demands of my job has changed from other reasons not related to the knee.

    Measured: Asked at 3 month, 12 months and 24 months after the surgery

  8. Life quality questionnaire 15 dimensions (15D) at 3, 12 and 24 months

    Life quality questionnaire 15 dimensions at 3 follow up visits. Scale from 15 (=exellent) to 75 (=worst) points.

    Measured: 3, 12 and 24 months

  9. Pain at rest and during walking on visual analoque scale (VAS)

    pain at rest and during walking on visual analoque scale (VAS) from 0 (=no pain) to 10 (=extreme pain)

    Measured: First day after the operation and at 3, 12 and 24 months

  10. Opioid usage

    Opioid usage mg/day

    Measured: Up to two weeks

  11. Blood loss

    Blood loss evaluated by the by measuring pre- and post-operative (first day after surgery) hemoglobin g/L. Difference between the pre-operative and post-operative Hemoglobin (g/L) values.

    Measured: First day after the operation

  12. Lenght of the hospital stay

    Length of hospital stay measured in days.

    Measured: Up to 1 week

  13. Operation time

    Time of the operation in hours and minutes checked form patient files.

    Measured: Day of the surgery

  14. Post-operative CRP

    post-op CRP as a indirect soft-tissue damage measure

    Measured: First day after the operation

  15. Knee swelling

    Knee swelling, knee diameter measured above the patella and compared to the unaffected size, the diameter difference in centimeters between the legs. Indirect soft-tissue damage measures

    Measured: First day after the operation

  16. Range of knee motion (ROM)

    Range of knee motion measured with goniometry as degrees at the ward on first post-operative day and ant the 3, 12 and 24 months visits.

    Measured: First day after the operation and at 3, 12 and 24 months visits

  17. Radiological outcome measures, alingment

    Knee alignment measured from post-operative weight bearing whole leg x-rays as degrees. Measured as the degrees between femoral mechanical axis line and tibial mechanical axis line.

    Measured: Weight bearing whole leg x-rays taken 3 months post-operatively.

  18. Radiological outcome measures, posterior condylar offset

    Post-op knee x-ray taken at the first post-operative day; posterior condylar offset, measured as maximal thickness of the posterior condyle projecting posteriorly to a straight line drawn as the extension of the posterior femoral shaft cortex, measured in millimeters

    Measured: post-operative knee x-rays taken within 1 week after the operation

  19. Radiological outcome measures, Insall-salvati ratio

    Measured from post-operative knee x-rays. Insall-salvati ratio: the length of the patellar tendon in millimeters divided by the length of the patella in millimeters.

    Measured: post-operative knee x-rays taken within 1 week after the operation

  20. Radiological outcome measures, Overhanging

    Measured from post-operative knee x-rays. Overhanging of the tibial or femoral component from medial lateral, posterior or anterior side measured as millimeters. The length between the bony edge to the edge of the component.

    Measured: post-operative knee x-rays taken within 1 week after the operation

  21. Radiological outcome measures, Notching

    Measured from post-operative knee x-rays. Notching of the anterior femoral cortex. The lenght in millimeters between the anterior femoral cortex and the anterior edge femoral component in sagittal x-ray.

    Measured: post-operative knee x-rays taken within 1 week after the operation

  22. Complications, revisons

    Revisions meaning re-operation of the knee due any reason. Checked from the patient files at 3, 12 and 24 months and five and ten years after surgery. Measured as number of revisions

    Measured: 3, 12 and 24 months and five and ten years

  23. Complications, infections

    Infections that recuire antibiotics or revision surgery. Checked from the patient files at 3, 12 and 24 months and five and ten years after surgery. Measured as number of infections

    Measured: 3, 12 and 24 months and five and ten years after surgery

  24. Complications, knee manipulation under anestesia due stiff knee

    Need for knee manipulations under anesthesia due stiff knee. Measured as number of manipulations. Checked form the patient files at 3, 12 and 24 months and five and ten years after surgery

    Measured: 3, 12 and 24 months and five and ten years after surgery.

  25. Complications, re-admission

    Unplanned post-operative re-admissions due to the knee operation. Measured as days at the ward.

    Measured: up to 24 months

  26. Complications, unplannet emergency unit visits

    Unplanned post-operative visits to the hospital emergency unit due to the knee operation, number of visits

    Measured: up to 24 months

  27. Costs

    Total cost of the treatment, measured as amount of money.

    Measured: up to 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Oct 2025
  2. Study startSep 2025 (estimated)
  3. Primary completionJul 2029 (estimated)
  4. Study completionSep 2037 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
170 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07201207
Sponsor's protocol ID
VARHA/28584/13.02.02/2024
Status last verified
May 2025
First submitted
28 Aug 2025
Last updated
1 Oct 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Robotic-assisted total knee arthroplasty and Manual total knee arthroplasty in people with Osteoarthritis, Knee, run by Satakunta Central Hospital.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 1 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Juha Kukkonen, dos MD (+358 45 177 7747, juha.kukkonen@sata.fi), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Oxford Knee score OKS at 24 months (time frame: 24 month). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Oct 2025.

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