SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022
Robot-assisted knee arthroplasty improves component positioning and alignment, but results are inconclusive on whether it improves clinical scores or reduces complications and revisions: a systematic overview of meta-analyses.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 5 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Improved alignment accuracy but similar early clinical outcomes with NAVIO imageless robotic-assisted vs. conventional total knee arthroplasty: a meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Tibia rotational alignment in total knee arthroplasty: Delphi consensus statements from European Knee Society (EKS).Archives of orthopaedic and trauma surgery · 2025Pooled it
- Robot-assisted pedicle screw insertion versus navigation-based and freehand techniques for posterior spinal fusion in scoliosis: a systematic review and meta-analysis.Spine deformity · 2024Pooled it
- Robotic-assisted mechanically aligned total knee arthroplasty does not lead to better clinical and radiological outcomes when compared to conventional TKA: a systematic review and meta-analysis of randomized controlled trials.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Complications and downsides of the robotic total knee arthroplasty: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Safety and Effectiveness of Robotic-Arm Assisted Total Knee Arthroplasty.Orthopaedic surgery · 2024Trial
- Functional alignment is associated with increased incidence of pre-balance, reduced soft-tissue release, and post-operative pain compared to mechanical alignment in patients undergoing simultaneous bilateral robotic-assisted TKA.Journal of robotic surgery · 2023Trial
- Comparison of early postoperative inflammatory response, blood-loss burden, and functional outcomes after robot-assisted and conventional total knee arthroplasty.Journal of robotic surgery · 2026Article
- Surgical treatment of varus unicompartmental knee osteoarthritis: indications, trends, and outcomes-a narrative review.Archives of orthopaedic and trauma surgery · 2026Review
- Does robot assistance improve the forgotten knee after total knee arthroplasty? A longitudinal prospective observational study.Journal of robotic surgery · 2026Observational
- Patient-reported outcomes of kinematically aligned robotic total knee replacement: a single center, single surgeon experience.Journal of robotic surgery · 2026Article
- Long-term outcomes and revision-free survival following robotic-assisted unicompartmental and total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2026Article
- Reduction in complication rate and hospital length of stay following robotic arm-assisted simultaneous bilateral total knee arthroplasty when compared to conventional techniques: a cohort study with minimum one year follow-up.Journal of robotic surgery · 2026Article
- Implant-agnostic, handheld wireless robotics: multicenter efficiency and learning curve for total knee arthroplasty.Journal of robotic surgery · 2026Observational
- Efficacy study of robot-assisted total knee arthroplasty in patients with different levels of medical experience.Journal of robotic surgery · 2026Article
- Functional versus mechanical alignment in robotic primary total knee arthroplasty: A meta-analysis.SICOT-J · 2026Article
- High-precision universality? A matched-pair sawbone study on the learning curve, accuracy, and implant interchangeability of a novel open-platform robotic UKA system.Frontiers in robotics and AI · 2026Article
- Robotic-assisted bi-cruciate stabilized TKA with a 3-degree varus inclination does not affect PROMs, regardless of pre-arthritic CPAK classification matching.Archives of orthopaedic and trauma surgery · 2025Article
- Application and postoperative rehabilitation effects of HURWA, Cori, and Brainlab robots in TKA under the ERAS concept.Journal of robotic surgery · 2025Article
- Robotic-assisted total knee arthroplasty achieves superior early postoperative outcomes compared to conventional techniques in patients with severe varus.Journal of experimental orthopaedics · 2025Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this systematic overview was to identify, synthesise and critically appraise findings of meta-analyses on robot-assisted versus conventional unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA). The hypothesis was that robotic assistance would reduce complications and revision rates, yield better clinical scores, and improve component positioning and alignment.
methodsTwo researchers independently conducted a literature search using Embase
resultsA total of ten meta-analyses were identified; four on robot-assisted UKA (n, 1880 robot-assisted vs. 2352 conventional UKA; follow-up, 0 to 60 months), seven on robot-assisted TKA (n, 4567 robot-assisted vs. 5966 conventional TKA; follow-up, 0 to 132 months). Of the meta-analyses on UKA, one found that robotic assistance reduced complication rates (relative risk (RR), 0.62), one found that it improved clinical scores (weighted mean difference (WMD), 19.67), three found that it extended operation times (WMD, 15.7 to 17.1 min), and three found that it improved component positioning and alignment (WMD, - 1.30 to - 3.02 degrees). Of the meta-analyses on TKA, two found that robotic assistance improved clinical scores (WMD, 1.62-1.71), two found that that it extended surgery times (WMD, 21.5-24.26 min), and five found that it improved component positioning and alignment (WMD, - 0.50 to - 10.07 degrees). None of the meta-analyses reported differences in survivorship between robot-assisted versus conventional knee arthroplasty.
conclusionRobot-assisted knee arthroplasty enabled more accurate component positioning and placement within target zones, but extended operation time considerably. Although robotic assistance improved component positioning, its benefits regarding clinical scores, patient satisfaction and implant survivorship remains to be confirmed. Finally, this overview revealed that six of the ten meta-analyses were of 'critically low quality', calling for caution when interpreting results. LEVEL OF EVIDENCE: IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.