Patient Sentiments of Robotic Versus Manual Total Knee Arthroplasty: National Social Media Analysis From 2011 to 2024

Total knee arthroplasty (TKA) is a widely performed procedure, with robotic-assisted TKA (rTKA) increasingly used as an alternative to traditional manual TKA (mTKA). While clinical outcomes of both techniques have been extensively studied, patient perceptions and preferences are worth exploring. As health care moves toward value-based models emphasizing patient-reported outcome measures, it is helpful to understand patient sentiment. This study analyzed social media discussions to evaluate patient-reported experiences with rTKA and mTKA.

Social media posts from 2011 to 2024 were collected from Instagram, Facebook, Twitter (X), Reddit, WebMD, and Quora. A total of 737 patient comments (414 rTKA, 323 mTKA) were analyzed using Valence Aware Dictionary and sEntiment Reasoner, a rule-based sentiment analysis tool developed for social media text, which assigns a score from -1.0 (negative) to +1.0 (positive). Comments were categorized into six themes: surgery experience, recovery process, pain management, support from family and friends, physical therapy, and emotional state. Independent t-tests and Mann-Whitney U-tests were used to compare sentiment distributions between groups, supplemented by bootstrap resampling and permutation testing.

Overall sentiment analysis revealed no statistically significant difference between rTKA and mTKA patient comments (P > 0.05). Thematic analysis showed similar sentiment distributions across all categories, with no significant differences in surgery experience, recovery, pain management, support system, physical therapy, or emotional state. The most discussed topics were pain management (rTKA: 54% and mTKA: 49%) and physical therapy (rTKA: 35% and mTKA: 43%). The rTKA patients more frequently discussed their surgical experience, while mTKA patients mentioned support from family and friends more often. Word cloud analyses indicated overlapping concerns across both groups, with frequent mentions of pain, recovery, and exercise.

Patient sentiment analysis across social media suggests that perceptions of robotic and manual techniques are similar. This reflects the current findings that robotic and manual techniques have similarities with respect to outcomes and results.