CORI-Assisted Personalized Alignment Versus Conventional Mechanical Alignment in Total Knee Arthroplasty: A Retrospective Comparative Study

Background: Robotic assistance and personalized alignment may alter operating work-flow and outcomes after total knee arthroplasty (TKA). We compared conventional me-chanically aligned TKA and CORI-assisted personalized TKA across two centres. Methods: The study includes 240 patients (120 per strategy) with repeated Oxford Knee Score (OKS), Knee Society Score (KSS) and Forgotten Joint Score (FJS-12) values through 12 months, operative phases and individual satisfaction responses. Exploratory one-year contrasts used Welch tests and Holm adjustment for four score outcomes. Results: Mean surgical time was 70.9 ± 7.9 versus 68.9 ± 7.7 min (difference 2.03, 95% CI 0.05–4.02; p = 0.044). At 12 months, OKS was 40.9 ± 2.7 versus 41.3 ± 3.7 (p = 0.304); KSS objective 90.0 ± 0.0 versus 88.7 ± 4.5 (p = 0.002); KSS Function 92.3 ± 4.0 versus 89.5 ± 5.5 (p < 0.001); and FJS-12 84.8 ± 0.4 versus 84.6 ± 0.7 (p = 0.0048). Satisfaction was reported by 99/120 (82.5%) versus 96/120 (80.0%) patients (Fisher p = 0.741). Conclusions: CORI-assisted personal-ized TKA was associated with modestly longer operative time and higher one-year KSS values. The FJS-12 mean difference was only 0.21 points, and OKS and satisfaction were similar. The observational design and nonrandom treatment selection do not isolate the contributions of robotic assistance and alignment philosophy.