Evidence map›Paper›PMID 40888957›Full record

Trial reportOrthopadie (Heidelberg, Germany)2026

Perioperative comparison between robotic-assisted and freehand total knee arthroplasty : A quasi-randomized controlled trial.

Filippo Migliorini, Luise Schäfer, Jens Schneider, Andrea Maria Nobili, Daniel Kämmer, Nicola Maffulli, Andreas Bell

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Orthopadie (Heidelberg, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Filippo MiglioriniDepartment of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, Ernst-Grube-Street 40, 06097, Halle (Saale), Germany. filippo.migliorini@uk-halle.de.ORCID http://orcid.org/0000-0001-7220-1221
Luise SchäferDepartment of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Kammerbruschstr. 8, 52152, Simmerath, Germany.
Jens SchneiderDepartment of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Kammerbruschstr. 8, 52152, Simmerath, Germany.
Andrea Maria NobiliDepartment of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Kammerbruschstr. 8, 52152, Simmerath, Germany.
Daniel KämmerDepartment of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Kammerbruschstr. 8, 52152, Simmerath, Germany.
Nicola MaffulliDepartment of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy.
Andreas BellDepartment of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Kammerbruschstr. 8, 52152, Simmerath, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe advent of navigation, followed by robotics in knee prosthetic surgery aims, among other things, to enhance the alignment of components and to improve the control of stress forces (i.e., weight, gravity, and static and dynamic stabilizers) on the bearing surface throughout the range of motion; however, the benefits of robotic-assisted total knee arthroplasty (TKA) are debated.

objectiveThis quasi-randomized controlled trial (RCT) compares robotic-assisted and conventional TKA, focusing on surgical duration, hospital stay and serum markers. It aims to address current gaps in the literature and clarify potential advantages. MATERIAL AND

methodsAll patients who received a TKA at the Department of Orthopedic Surgery of the Eifelklinik St. Brigida in Simmerath, Germany, between 2021 and 2025 were prospectively invited to participate in the present clinical trial. All patients followed the same clinical, imaging, and anesthesiological presurgical and postsurgical pathways irrespective of their allocation. All surgeries were performed using a standard medial parapatellar approach and a functional alignment philosophy. Both groups received the same implants, and patients followed the same postoperative physiotherapy program. Deviation from the planned surgical procedure and rehabilitation protocol warranted exclusion from the study. For patients allocated to robotic-assisted TKA, the CORI system (Smith & Nephew plc, Watford, United Kingdom) was used.

resultsA total of 1099 patients completed the study, 59% (649 of 1099) of the patients were women and 50% (547 of 1099) of TKAs were performed on the left side. The mean body mass index (BMI) was 30.2 ± 4.9 kg/m

conclusionRobotic-assisted TKA was associated with lower serum C‑reactive protein levels. No difference was found in the length of hospitalization and erythropoietic function in serum. Although the surgical execution of conventional TKA was statistically significantly faster, the clinical relevance of the endpoint surgical duration is negligible.

Indexed as

Arthroplasty, Replacement, KneeRobotic Surgical ProceduresAgedC-Reactive ProteinFemaleHumansLength of StayMaleMiddle AgedOperative TimeProspective StudiesTreatment OutcomeC-Reactive ProteinArthroplasty outcomesFunctional recoveryImplant alignmentSoft tissue balanceSurgical accuracy

Identifiers

PMID40888957
PMCPMC12804292

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Registered trials

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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.