{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:59:58Z","timestamp":1791622798375,"version":"4.3.4"},"reference-count":61,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Our systematic review and meta\u2010analysis sought to assess how technology\u2010assistance impacts (1) post\u2010operative pain and (2) opioid use in patients undergoing primary total knee arthroplasty (TKA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four online databases were queried for studies published up to October 2021 that reported on pain and opioid usage between technology\u2010assisted and manual TKA (mTKA) patients. Mantel\u2013Haenszel (M\u2013H) models were utilized to calculate pooled mean difference (MDs) and 95% confidence interval (CIs). Subgroup analyses were conducted to isolate robotic\u2010arm assisted (RAA) and computed\u2010assisted navigation (CAN) cohorts. Risk of bias was assessed for all included non\u2010randomized studies with the Methodological Index for Non\u2010Randomized Studies (MINORS) tool. For the randomized control trials included in our study, the Detsky scale was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our analysis included 31 studies, reporting on a total of 761,300 TKAs (mTKA:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009753,554; Computer\u2010Assisted Navigation (CAN):\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,309; Robotic\u2010Arm Assisted (RAA):\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096437). No differences were demonstrated when evaluating WOMAC (MD: 0.00, 95% CI \u2212\u20090.69 to 0.69;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.00), KSS (MD: 0.01, 95% CI \u2212\u20091.46 to 1.49;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.99), KOOS (MD \u2212\u20092.91, 95% CI \u2212\u20096.17 to 0.34;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08), and VAS (MD \u2212\u20090.54, 95% CI \u2212\u20091.01 to \u2212\u20090.007;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) pain scores between cohorts. There was mixed evidence regarding how opioid consumption differed between TKA techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present analysis demonstrated no difference in terms of pain across a variety of utilized patient\u2010reported pain measurements. However, there were mixed results regarding how opioid consumption varied between manual and technology\u2010assisted cohorts, particularly in the immediate post\u2010operative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-022-07098-w","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T04:03:52Z","timestamp":1660881832000},"page":"1370-1381","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain"],"prefix":"10.1002","volume":"31","author":[{"given":"Andrew G.","family":"Kim","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cleveland Clinic Foundation 44195 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Bernhard","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cleveland Clinic Foundation 44195 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Acu\u00f1a","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cleveland Clinic Foundation 44195 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria S.","family":"Wu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cleveland Clinic Foundation 44195 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9214-2756","authenticated-orcid":false,"given":"Atul F.","family":"Kamath","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cleveland Clinic Foundation 44195 Cleveland OH USA"},{"name":"<!--<label>2<\/label>--> Center for Hip Preservation, Orthopaedic and Rheumatologic Institute Cleveland Clinic Foundation 9500 Euclid Ave, Mail Code A41 44195 Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.03.005"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010017\u20103509\u2010z"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1302\/2633\u20101462.12.BJO\u20102019\u20100004.R1"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010021\u201004067\u20109"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.2016.28.1.1"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.12.012"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.04.037"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100990\u2010y"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(92)90085\u20102"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.01148"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201014\u2010321"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010016\u20103307\u2010z"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.96B5.32516"},{"key":"e_1_2_8_15_2","first-page":"280","article-title":"Opioid use in robotic\u2010arm assisted total knee arthroplasty: a comparison to conventional manual total knee arthroplasty","volume":"37","author":"Greiner JJ","year":"2020","journal-title":"Surg Technol Int"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000150564.31880.c4"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2021.01.017"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100038\u20101641729"},{"key":"e_1_2_8_19_2","unstructured":"Higgins Julian PT and Green S(2011)Cochrane Handbook for Systematic Reviews of Interventions|Cochrane Training.https:\/\/training.cochrane.org\/cochrane\u2010handbook\u2010systematic\u2010reviews\u2010interventions. Accessed 23 Oct 2021"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.94B2.27454"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11420\u2010018\u20109614\u20108"},{"key":"e_1_2_8_22_2","article-title":"Malpositioning of prosthesis: patient\u2010specific total knee arthroplasty versus standard off\u2010the\u2010shelf total knee arthroplasty","volume":"1","author":"Kang K\u2010T","year":"2017","journal-title":"J Am Acad Orthop Surg Glob Res Rev"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1302\/2058\u20105241.4.190022"},{"key":"e_1_2_8_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.03.042"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.100B7.BJJ\u20102017\u20101449.R1"},{"key":"e_1_2_8_26_2","first-page":"441","article-title":"Robotic\u2010arm assisted total knee arthroplasty demonstrated soft tissue protection","volume":"30","author":"Khlopas A","year":"2017","journal-title":"Surg Technol Int"},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101684014"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999.0000000000000000"},{"key":"e_1_2_8_29_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.00142"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.00791"},{"issue":"1","key":"e_1_2_8_31_2","first-page":"78","article-title":"Transitioning a practice to robotic total knee arthroplasty is correlated with favorable short\u2010term clinical outcomes\u2014a single surgeon experience","volume":"35","author":"King CA","year":"2020","journal-title":"J Knee Surg"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003509"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010019\u201005808\u20105"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.99B9.BJJ\u20102016\u20101343.R1"},{"key":"e_1_2_8_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010011\u20101297\u20104"},{"issue":"3","key":"e_1_2_8_36_2","first-page":"337","article-title":"Improved component placement accuracy with robotic\u2010arm assisted total knee arthroplasty","volume":"35","author":"Mahoney O","year":"2020","journal-title":"J Knee Surg"},{"key":"e_1_2_8_37_2","doi-asserted-by":"crossref","unstructured":"MarchandKB MoodyR SchollLY Bhowmik\u2010StokerM TaylorKB MontMA MarchandRCResults of robotic\u2010assisted versus manual total knee arthroplasty at 2\u2010year follow\u2010up.J Knee Surg(2021)10.1055\/s\u20100041\u2010173134934187064","DOI":"10.1055\/s-0041-1731349"},{"key":"e_1_2_8_38_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101683977"},{"key":"e_1_2_8_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/15563316211028568"},{"key":"e_1_2_8_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.01.072"},{"key":"e_1_2_8_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2020.09.014"},{"key":"e_1_2_8_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119838533"},{"key":"e_1_2_8_43_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003583"},{"key":"e_1_2_8_44_2","doi-asserted-by":"publisher","DOI":"10.1186\/s43019\u2010021\u201000114\u20102"},{"key":"e_1_2_8_45_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.01338"},{"key":"e_1_2_8_46_2","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2020.43763"},{"key":"e_1_2_8_47_2","unstructured":"SamuelLT KarnutaJM BanerjeeA BriskinI CantrellWA GeorgeJW Higuera\u2010RuedaCA KamathAF KhlopasA KlikaA KrebsVE MeskoNW MontMA MurrayTG PiuzziNS ShahP StearnsK SultanAA MolloyRMRobotic arm\u2010assisted versus manual total knee arthroplasty: a propensity score\u2010matched analysis.J Knee Surg(2021)10.1055\/s\u20100041\u2010173132334187067"},{"key":"e_1_2_8_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u201012\u201016"},{"issue":"10","key":"e_1_2_8_49_2","first-page":"s1251","article-title":"Functional impact of navigation\u2010assisted minimally invasive total knee arthroplasty","volume":"28","author":"Seon JK","year":"2005","journal-title":"Orthopedics"},{"key":"e_1_2_8_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2005.08.024"},{"key":"e_1_2_8_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.08.014"},{"key":"e_1_2_8_52_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS\u2010D\u201020\u201000654"},{"key":"e_1_2_8_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010015\u20102314\u20107"},{"key":"e_1_2_8_54_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445\u20102197.2003.02748.x"},{"key":"e_1_2_8_55_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010016\u20103996\u20102"},{"key":"e_1_2_8_56_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B4.18094"},{"issue":"4","key":"e_1_2_8_57_2","first-page":"47","article-title":"Computer\u2010assisted surgery versus manual total knee arthroplasty: a case\u2010controlled study","volume":"88","author":"Stulberg SD","year":"2006","journal-title":"J Bone Jt Surg Am"},{"key":"e_1_2_8_58_2","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100031\u20101299670"},{"key":"e_1_2_8_59_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.01401"},{"key":"e_1_2_8_60_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447\u201020130426\u201026"},{"key":"e_1_2_8_61_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11548\u2010013\u20100968\u20106"},{"key":"e_1_2_8_62_2","unstructured":"ZakSG YeroushalmiD TangA MeftahM SchnaserE SchwarzkopfRThe use of navigation or robotic\u2010assisted technology in total knee arthroplasty does not reduce postoperative pain.J Knee Surg(2021)10.1055\/s\u20100041\u2010173531334530477"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07098-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-022-07098-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-022-07098-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-022-07098-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:34:32Z","timestamp":1760884472000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-022-07098-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,19]]},"references-count":61,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1007\/s00167-022-07098-w"],"URL":"https:\/\/doi.org\/10.1007\/s00167-022-07098-w","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,19]]},"assertion":[{"value":"14 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A.F.K. reports the following disclosures: research support (Signature Orthopaedics), paid presenter or speaker (DePuy Synthes and Zimmer Biomet), paid consultant (DePuy Synthes andd Zimmer Biomet), stock or stock options (Zimmer Biomet, Johnson & Johnson, and Procter & Gamble), IP royalties (Innomed), and board or committee member (AAOS, AAHKS, and Anterior Hip Foundation). The remaining authors have nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"As our analysis used publicly available and deidentified data, it was exempt from Institutional Review Board (IRB) approval.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}