SynthesisJournal of robotic surgery2026
Cementless versus cemented fixation in robotic-assisted total knee arthroplasty: a systematic review and meta-analysis.
Synthesis in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
6 authors.
Funding
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Abstract
Robotic assistance can improve the reproducibility of bone preparation in total knee arthroplasty (TKA), but whether this translates into different outcomes for cementless and cemented fixation is uncertain. PubMed, Embase.com, Web of Science Core Collection and CENTRAL were searched from inception to 29 July 2026 for comparative studies of cementless versus cemented primary robotic-assisted TKA. The review was prospectively registered in PROSPERO (CRD420261446055). Random-effects models used restricted maximum likelihood estimation and Hartung-Knapp adjustment. Risk of bias and certainty were assessed using ROBINS-I and GRADE, respectively. Ten studies represented by 11 reports were included. In three-study syntheses, the pooled risk ratio (RR) was 0.63 for mid-term all-cause revision (95% confidence interval [CI] 0.09 to 4.53; I²=0%) and 1.03 for manipulation under anaesthesia (95% CI 0.09 to 11.74; I²=31.6%). The pooled estimate suggested a potential reduction in operative time in selected settings (mean difference [MD] -12.91 min, 95% CI -36.38 to 10.55; I²=94.4%), but it was imprecise and highly heterogeneous. The length-of-stay estimate was imprecise (MD -0.24 days, 95% CI -3.67 to 3.19; I²=0%). Adjusted registry and institutional estimates were directionally mixed and were kept separate from crude risks. Certainty was very low for every pooled outcome. Available observational evidence is insufficient to favour either fixation strategy for survival or stiffness outcomes after robotic-assisted TKA. Any potential reduction in operative time appears setting dependent and remains uncertain. PROSPERO registration: CRD420261446055.
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Registered trials
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