Robotic-assisted Total Knee Arthroplasty (RA-TKA) enhances precision but is historically associated with increased operative times and workflow disruption. This study evaluates whether integrating a novel open-platform robotic effector into an established, familiar navigation workflow mitigates the learning curve and maintains total operative time compared to standard navigation. A retrospective comparative analysis was performed on 236 primary TKAs (142 NAV-TKA vs. 94 RA-TKA) performed by a single high-volume surgical team. Operative times were segmented into five phases using synchronized system logs. Educational cases were excluded. The learning curve was analyzed using Cumulative Sum (CUSUM) control charts. Multi-way analysis across independent cohorts showed a significant global variation in total skin-to-skin time ( p < 0.001). However, post-hoc pairwise testing demonstrated that while the initial learning phase was significantly longer (Median: 84.00 min), the steady-state proficiency phase (Median: 77.00 min) achieved a comparable time profile to the legacy navigation workflow (Median: 81.00 min; p > 0.017), avoiding an overall sustained time penalty. CUSUM analysis identified a learning curve of 58 cases. In the proficiency phase, the active robotic resection time was significantly faster than manual navigated resection (17.95 vs. 19.08 min; p = 0.009). The open-platform robotic system successfully integrated into the clinical workflow without introducing an overall sustained time penalty. Retaining a familiar interface effectively cushions the initial efficiency loss typical of closed platforms. Once proficiency is attained, active robotic assistance significantly enhances mechanical resection speed, offsetting the mandatory intra-operative planning time investment.

Purpose: The analysis of knee joint biomechanics under intraoperative‐like conditions is fundamental to support surgical decisions and improve clinical outcomes. Many experimental systems developed in recent years are characterized by high complexity and limited portability, which may restrict the reproduction of surgical intraoperative workflows. Therefore, this study describes the design and experimentally validates a compact and portable testing platform capable of accurately analysing knee tibio‐femoral and patello‐femoral kinematics and laxity under intraoperative‐like conditions. Methods: The system integrates motion capture, mechanical fixation, motor‐driven actuation, force measurement and dedicated software into a unique platform. It enables passive and active open‐chain knee motions, as well as standardized ligament laxity testing. Tibio‐femoral and patello‐femoral kinematics are simultaneously recorded while quadriceps and external forces are measured respectively through mono‐axial and tri‐axial load cells. System accuracy and repeatability were assessed through load cell calibration and dynamic testing on a synthetic knee model. Transportability, setup time and overall performance were evaluated under realistic ex vivo experimental conditions. Results: Validation demonstrated close agreement between set and measured loads, with measurement accuracies of approximately 1% for quadriceps forces and 0.75% for externally applied knee forces. Motor‐driven motion showed high repeatability, with mean standard deviations of 0.51° for flexion–extension cycles and 1.62° for multiple dynamic flexion tests. Motion capture calibration achieved a pointer tip positional error of approximately 0.20 mm. Ex vivo testing confirmed reliable reproduction of knee motion and highly reproducible measurement, with rapid set‐up and workflow smoothness. Conclusion: The system represents a portable, accurate, repeatable and validated experimental platform for biomechanical assessment of knee joint kinematics and laxity under intraoperative‐like conditions. Its modular design, rapid setup and capability to combine kinematic and kinetic measurements make it a valuable tool for investigating the biomechanical impact of surgical techniques or implants, and patient‐specific joint behaviour in ex vivo settings. Level of Evidence: N/A.

Goal: Organ perfusion is a vast subject with several techniques, the most common being Hypothermic Machine Perfusion (HMP) and Normothermic Machine Perfusion (NMP). In this paper, a new machine developed at the Biolab of the University of Florence has been tested to validate its capability to perform a well-controlled Oxygenated Rewarming (COR) phase and maintain stability during the NMP phase. Methods: The tests (n = 5) were conducted on fresh porcine livers and evaluated according to liver perfusion standards. The developed machine is based on a previous version, with an integrated control and sensor system and a complete mechanical and electronic redesign. Results: The results demonstrate the excellent usability of the machine and its ability to effectively maintain the organs in good condition. The new system performed well, and the measures made on the livers were satisfactory for good preservation of the organ. Conclusion: This study showed the effectiveness of the developed machine. Future development of the system will include a more sophisticated control system to ensure the correct parameters for perfusion.