Robot-assisted versus freehand cannulated-screw fixation for femoral neck fractures: a systematic review of technical, clinical and adoption outcomes.
J Robot SurgSep 15, 2026 (epub)
Gaurav Jha, Amrita Dhar, Aftab Arif et al.
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In 30 seconds
This systematic review compared robot-assisted and freehand cannulated-screw fixation for femoral neck fractures in adults, analyzing 16 studies with 1,293 participants. Robot-assisted fixation demonstrated fewer guide-wire manipulations, greater screw-placement accuracy, and 13.9 fewer fluoroscopic acquisitions per procedure (95% CI -20.3 to -7.5).
Key findings
- Robot-assisted fixation resulted in 13.9 fewer fluoroscopic acquisitions per procedure.
- Greater screw-placement accuracy was observed with robot-assisted techniques.
- Lower risks of union failure and avascular necrosis were associated with robot-assisted fixation.
- Heterogeneity was substantial for several continuous outcomes, indicating variable benefits.
Why it matters
Understanding the comparative effectiveness of robot-assisted versus freehand techniques is crucial for optimizing surgical outcomes in femoral neck fractures. Improved technical precision may enhance patient care, although clinical superiority remains uncertain.