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Updated: Mar 22, 2026
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Robot-assisted total knee arthroplasty is associated with reduced early anterior knee pain compared with conventional
Jiajie Yan1, Shuangshuang Deng2, Qiuyan Chen3
1Bone joint and Sports Medical Center, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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.
