ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026
Robotic arm-assisted total knee arthroplasty reduces postoperative inflammatory response and blood loss compared to manual total knee arthroplasty: A matched-pairs analysis of 688 patients.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- 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
- Less inflammation and early functional recovery after total hip arthroplasty performed with robotic arm assistance than with computed tomography-based navigation: a propensity score-matched comparative study.International orthopaedics · 2026Article
- Reduced postoperative inflammation and blood loss after robotic arm-assisted unicompartmental compared with total knee arthroplasty: A propensity score-matched analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Robotic-assisted total knee arthroplasty: radiological precision, clinical outcomes, and benchmarks for emerging systems.Journal of robotic surgery · 2026Review
- Periprosthetic knee fractures following robotic-assisted total knee arthroplasty: an observational incidence study.Journal of robotic surgery · 2026Observational
- Risk of periprosthetic joint infection within 1 year following robotic-assisted versus conventional primary total knee arthroplasty: a propensity-score-matched cohort study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026Article
- Robotic Assistance for Low-Volume Total Knee Arthroplasty Surgeons Is Associated With Comparable Perioperative Outcomes Related to Those of High-Volume Surgeons Using Conventional Techniques.Arthroplasty today · 2026Article
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Abstract
purposeRobotic arm-assisted total knee arthroplasty (raTKA) has demonstrated several advantages over manual TKA (mTKA), including enhanced early recovery. Reduced soft tissue trauma and avoidance of femoral intramedullary canal opening have been hypothesised to lower the systemic inflammatory response. However, findings from previous small-cohort studies have been inconsistent. This study aimed to evaluate postoperative systemic inflammation in a large patient cohort.
methodsPatients who underwent raTKA using the Mako® system were matched with patients who received mTKA based on gender, American Society of Anesthesiologists score, age and body mass index. This matching process resulted in two comparable cohorts, each comprising 344 patients. Blood samples were collected preoperatively, 6 h postoperatively, and on postoperative Days 3 and 5. Measurements included C-reactive protein (CRP), white blood cell count (WBC) and calculated blood loss.
resultsThe highest CRP levels were observed on postoperative Day 3 in both groups. The median CRP increase was significantly lower in the raTKA group compared with the mTKA group on Day 3 (4.4 vs. 5.3 mg/dL; p = 0.002) and slightly lower on Day 5 (3.5 vs. 3.8 mg/dL; p = 0.349). The WBC count peaked at 6 h postoperatively in both groups before steadily declining, with no significant difference between groups. The median operation time was significantly longer in the raTKA group (92 vs. 86 min; p < 0.001). Despite a longer surgical duration, the median blood loss was significantly lower in the raTKA group (653 vs. 729 mL; p = 0.005).
conclusionIn the largest comparative analysis to date, raTKA was linked to significantly lower postoperative CRP levels than mTKA. Reduced soft tissue trauma, avoidance of femoral intramedullary canal violation and significantly lower blood loss may all contribute to a diminished systemic inflammatory response, potentially explaining the improved early functional outcomes observed with raTKA. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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