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Whether these approaches are associated with different clinically relevant postoperative outcomes remains uncertain. To evaluate associations between surgical technique and postoperative pain, range of motion, and function across conventional, MAKO-assisted, and Verasense-guided CR-TKA, and explore whether preoperative severity modified associations with postoperative outcomes. The single-centre cohort included 173 knees in 139 patients (36 Conventional, 92 MAKO, 45 Verasense). Analyses proceeded from post hoc favourable change to principal covariate-adjusted postoperative outcomes, followed by post hoc baseline-severity interactions. Principal models adjusted for baseline value, age, sex, and body mass index. Knee-level outcomes accounted for within-patient clustering; the Knee Society Function Score was analysed once per patient. Holm correction was applied within each stated test family. No outcome showed a Holm-adjusted group difference in favourable improvement or adjusted postoperative status. Verasense versus MAKO showed greater pain improvement (0.769 points; Holm P\u2009=\u20090.2195) and lower adjusted postoperative pain (\u22120.318 points; Holm P\u2009=\u20090.2546), but neither met the corrected criterion. Postoperative pain was zero in 125 of 149 knees (83.9%). The Knee Society Function Score severity interaction disappeared within the baseline range shared by all groups. We found no robust evidence that conventional instrumentation, geometry-based MAKO assistance, and load-based Verasense guidance were associated with different postoperative outcomes or that preoperative severity showed a reproducible technique-dependent association with outcomes. The Verasense-versus-MAKO pain pattern was hypothesis-generating and established neither superiority nor equivalence.<\/jats:p>","DOI":"10.1007\/s11701-026-03954-w","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T06:37:19Z","timestamp":1789454239000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postoperative outcomes after conventional, robotic-arm-assisted, and pressure-sensor-guided cruciate-retaining total knee arthroplasty: a retrospective cohort study"],"prefix":"10.1007","volume":"20","author":[{"given":"Tsz-Lung","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria Yan-Ting","family":"Lam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueyou","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingde","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rex Wang-Fung","family":"Mak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis Cham-Kit","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Shu-Hang","family":"Yung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-9286","authenticated-orcid":false,"given":"Michael Tim-Yun","family":"Ong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"issue":"6suppl4","key":"3954_CR1","doi-asserted-by":"publisher","first-page":"2325967119S0023","DOI":"10.1177\/2325967119S00231","volume":"7","author":"M Ettinger","year":"2019","unstructured":"Ettinger M, Savov P, Windhagen H, Mielke E, Calliess T (2019) Cruciate retaining versus posterior stabilized total knee arthroplasty for the treatment of valgus osteoarthritis? 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