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Background and objective <p>Anterior knee pain (AKP) remains one of the most common complaints following total knee arthroplasty (TKA), with an incidence ranging from 4% to 60%. Robot-assisted TKA (RA-TKA) has shown enhanced precision in component positioning and alignment, yet its influence on postoperative AKP remains insufficiently explored. This study compared the mid-term and long-term effects of RA-TKA and conventional manual TKA (CM-TKA) on AKP severity, knee function, and joint mobility.</p> Methods <p>A&#xa0;retrospective cohort of obese patients undergoing primary TKA for advanced (Kellgren-Lawrence grade&#xa0;4) osteoarthritis between 2020 and 2023 was analyzed. Propensity score matching (PSM) was applied to minimize baseline bias, yielding 88 well-balanced pairs of RA-TKA and CM-TKA patients. Outcomes included AKP intensity measured by the numeric rating scale (NRS), Knee Society Score (KSS) and active knee range of motion (ROM) at 3, 6, 9, and 12&#xa0;months postoperatively.</p> Results <p>At 3&#xa0;months, RA-TKA patients reported lower AKP scores compared to CM-TKA (17.5 ± 8.1 vs. 24.6 ± 10.7, <i>p</i> = 0.034), although this difference disappeared in later follow-ups. By 12&#xa0;months, RA-TKA yielded higher KSS (37.5 ± 6.2 vs. 34.4 ± 5.6, <i>p</i> = 0.042), greater flexion (110.3 ± 11.8° vs. 107.5 ± 12.5°, <i>p</i> = 0.044), and better extension (3.6 ± 1.4° vs.&#xa0;4.1 ± 1.5°, <i>p</i> = 0.020). Both groups exhibited peak AKP at 3&#xa0;months, with gradual recovery thereafter.</p> Conclusion <p>The RA-TKA provided superior short-term improvement in AKP and functional recovery compared to conventional TKA, particularly within the early postoperative phase when AKP is most pronounced. Although long-term outcomes were comparable, the robotic technique offered measurable benefits in early pain reduction and joint mobility, highlighting its clinical value in obese patients undergoing TKA.</p> Graphic abstract <p></p>

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Robot-assisted total knee arthroplasty is associated with reduced early anterior knee pain compared with conventional techniques

  • 期刊论文

  • 发表日期：

    2026年3月20日

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  • Jiajie Yan,
  • Shuangshuang Deng,
  • Qiuyan Chen,
  • Ning Liu,
  • Songwei Huan,
  • Min Zhen,
  • Jiamin Zhang,
  • Yanyan Gao

摘要

Background and objective

Anterior knee pain (AKP) remains one of the most common complaints following total knee arthroplasty (TKA), with an incidence ranging from 4% to 60%. Robot-assisted TKA (RA-TKA) has shown enhanced precision in component positioning and alignment, yet its influence on postoperative AKP remains insufficiently explored. This study compared the mid-term and long-term effects of RA-TKA and conventional manual TKA (CM-TKA) on AKP severity, knee function, and joint mobility.

Methods

A retrospective cohort of obese patients undergoing primary TKA for advanced (Kellgren-Lawrence grade 4) osteoarthritis between 2020 and 2023 was analyzed. Propensity score matching (PSM) was applied to minimize baseline bias, yielding 88 well-balanced pairs of RA-TKA and CM-TKA patients. Outcomes included AKP intensity measured by the numeric rating scale (NRS), Knee Society Score (KSS) and active knee range of motion (ROM) at 3, 6, 9, and 12 months postoperatively.

Results

At 3 months, RA-TKA patients reported lower AKP scores compared to CM-TKA (17.5 ± 8.1 vs. 24.6 ± 10.7, p = 0.034), although this difference disappeared in later follow-ups. By 12 months, RA-TKA yielded higher KSS (37.5 ± 6.2 vs. 34.4 ± 5.6, p = 0.042), greater flexion (110.3 ± 11.8° vs. 107.5 ± 12.5°, p = 0.044), and better extension (3.6 ± 1.4° vs. 4.1 ± 1.5°, p = 0.020). Both groups exhibited peak AKP at 3 months, with gradual recovery thereafter.

Conclusion

The RA-TKA provided superior short-term improvement in AKP and functional recovery compared to conventional TKA, particularly within the early postoperative phase when AKP is most pronounced. Although long-term outcomes were comparable, the robotic technique offered measurable benefits in early pain reduction and joint mobility, highlighting its clinical value in obese patients undergoing TKA.

Graphic abstract