Impact of Robotic-Assisted Technology on Joint Awareness Following Total Joint Arthroplasty: A Systematic Review and Meta-Analysis.

Abstract

Joint awareness reflects patient satisfaction and prosthesis integration after arthroplasty. This study aimed to evaluate joint awareness differences between robotic-assisted joint arthroplasty (R-JA) and manual joint arthroplasty (M-JA) across various joint sites and follow-up periods. A systematic search was conducted in four major databases for studies published between January 1, 2012, and February 1, 2025. Cohort studies and randomized controlled trials comparing R-JA and M-JA were included. Studies reporting the Forgotten Joint Score-12 (FJS-12) were selected, with data extracted and categorized by follow-up duration: short-term (< one year), mid-term (one to two years), and long-term (> two years). Descriptive statistics and a random-effects model were applied. A total of 39 studies were included, encompassing 13,289 joints, comprising 10,037 total knee arthroplasties (TKAs), 2,746 total hip arthroplasties (THAs), and 506 unicompartmental knee arthroplasties (UKAs). The meta-analysis indicated that R-TKA achieved higher FJS-12 than M-TKA across all follow-up periods (short-term: mean difference (MD): 5.72, 95% confidence intervals (CIs): 1.37 to 10.07; mid-term: MD: 3.27, 95% CI: 0.11 to 6.42; long-term: MD: 8.37, 95% CI: 0.86 to 15.89). Similarly, R-THA consistently outperformed M-THA in joint awareness across all follow-up periods (within one year: MD: 6.60, 95% CI: 3.47 to 9.74; one to two years: MD: 7.19, 95% CI: 1.21 to 13.17; over two years: MD: 1.92, 95% CI: 0.46 to 3.39). The R-UKA demonstrated superior FJS-12 in short-term (MD: 7.88, 95% CI: 4.02 to 11.74) and mid-term (MD: 12.96, 95% CI: 7.27 to 18.66) follow-ups, but no significant difference was observed in the long-term follow-up (MD: 9.06, 95% CI: -7.76 to 25.89). This study found that R-JA improved joint awareness after total joint arthroplasty, with a consistent advantage in TKA and THA across all follow-up periods, while the benefits in UKA were limited to within 2 years.