Comparing robot-assisted and conventional surgery in knee replacement: A meta-analysis of surgical-site wound complications and recovery outcomes

Objective: This meta-analysis aims to assess the impact of robotic and open-cut forms on postoperative complications in knee replacement surgeries. Method: A comprehensive and systematic search was conducted on four significant databases using keywords derived from 'robot,' 'robot-assisted knee replacement (TAKR),' 'osteoarthritis,' 'knee arthroplasty,' 'wound healing,' 'knee replacement,' and 'postoperation' from the earliest available records until March 2024. A total of 590 publications were explored, and 16 related randomized clinical trials (RCTs) were analyzed in depth to unveil the role of robots in knee replacement surgery. In this meta-review, different parameters were adopted to evaluate various aspects: operation duration was used to measure the time from the primary incision to the wound closure after the surgery; Knee Society Score (KSS) and Hip Knee Ankle Angle (HKA) were used to evaluate the recovery and imaging features of the knees. Results: Data suggests there was little difference between the two methods except that the operation duration was higher in the robot-assisted group than in the conventional ones. Conclusions: In broad terms, this meta-analysis indicates that employing robotics does not decrease specific post-surgical complications, such as wound infections and painful feelings. However, this advanced medical technology of robots' application helps reduce blood loss and drainage compared to patients with conventional surgery. Consequently, utilizing a robotic approach for knee replacement surgeries may only provide moderate promotion for wound recovery after the surgery. This insight is valuable for surgeons when choosing the most appropriate operative approach. (c) 2025 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).