Chareancholvanich K.Pornrattanamaneewong C.Udompanich R.Awirotananon K.Narkbunnam R.Mahidol University2025-03-192025-03-192025-01-01International Orthopaedics (2025)03412695https://repository.li.mahidol.ac.th/handle/123456789/106709Purpose: While robotic-assisted total knee arthroplasty (RA-TKA) has demonstrated improved surgical precision, its impact on early postoperative pain management remains unclear. This study compared early postoperative pain outcomes between RA-TKA and conventional TKA (C-TKA). Methods: In this retrospective study, 230 consecutive patients (309 knees) who underwent primary TKA were analyzed: 143 patients (181 knees) in the C-TKA group and 87 patients (128 knees) in the RA-TKA group. Pain scores at rest and during movement were assessed using the Numerical Pain Rating Scale for 72 h postoperatively. Secondary outcomes included opioid consumption and length of hospital stay. Results: While pain scores at rest showed no significant differences between groups, RA-TKA patients reported significantly lower pain scores during movement at 24 h post-surgery (p = 0.023). The RA-TKA group demonstrated significantly reduced opioid consumption during the first 48 postoperative hours (p = 0.001 for 0-24 h; p = 0.03 for 24-48 h) and shorter length of hospital stay (p = 0.011). Subgroup analysis of unilateral procedures showed similar advantages in the RA-TKA group. Conclusion: RA-TKA was associated with reduced pain during movement, decreased opioid consumption, and shorter hospital stay in the early postoperative period compared to C-TKA.MedicineArticleSCOPUS10.1007/s00264-025-06451-12-s2.0-8600033367914325195