Mode
Text Size
Log in / Sign up

Periprosthetic fracture rate 0.11% after tracker pin placement in robotic and navigated TKARobotic and navigation systems show low fracture rates in knee surgery

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Interpret the 0.11% periprosthetic fracture rate cautiously due to pooling of distinct systems and missing risk factor data.

This meta-analysis, published as a commentary on a prior meta-analysis by Peñaherrera-Carrillo et al. (2026), evaluates the incidence of periprosthetic fracture after tracker pin placement in total knee arthroplasty (TKA) using robotic and navigation-assisted systems. The analysis pooled data from 13,217 procedures and reported a periprosthetic fracture incidence of 0.11%.

The authors note several important limitations. The meta-analysis aggregated biomechanically distinct robotic and computer navigation systems, which may have different pin placement techniques and risks. Additionally, the absence of bone mineral density data and omission of platform-specific differences in pin geometry, cortical engagement protocol, and drilling technique limit the interpretability of the pooled estimate.

Given these methodological concerns, the reported 0.11% fracture rate should be interpreted cautiously. The study highlights an under-reported complication but underscores the need for more granular data accounting for surgical system type and patient-specific risk factors before drawing firm clinical conclusions.

When patients undergo total knee arthroplasty (TKA), surgeons often use robotic or navigation-assisted systems to improve precision. A key part of this technology involves placing a tracker pin. Because these pins are inserted into the bone, there is always a concern about whether they might cause a fracture near the implant site.

Data from 13,217 procedures shows that the incidence of periprosthetic fractures—those occurring near the surgical site—was only 0.11%. This low number suggests that the current methods for placing tracker pins are generally safe for patients undergoing these types of knee replacements.

While the results are encouraging, researchers noted some limitations in the data. The study grouped different types of robotic and navigation systems together without looking at specific differences in drill techniques or bone density. Because of these missing details, it is hard to know exactly how different surgical techniques might change the risk for individual patients.

What this means for you:
Data from over 13,000 surgeries shows a very low fracture rate (0.11%) following tracker pin placement in knee replacements.

Common questions

Is it safe to use tracker pins during robotic knee surgery?

Data from 13,217 procedures shows a very low fracture rate of only 0.11% for those who received the procedure. This suggests that the placement of these pins is generally safe, though individual risks can vary based on factors like bone density not included in this specific data set.

What are periprosthetic fractures?

A periprosthetic fracture is a break in the bone that occurs near the site where an artificial joint, such as a knee replacement, was implanted. In this study, these were specifically monitored following the placement of tracker pins during surgery.

How many patients were included in this study?

The analysis included data from 13,217 procedures involving patients undergoing total knee arthroplasty using robotic and navigation-assisted systems. This large sample size provides a broad look at the safety of tracker pin placement.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
Peñaherrera-Carrillo et al. recently presented a systematic review and meta-analysis in the Journal of Robotic Surgery (2026) reporting a pooled periprosthetic fracture incidence of 0.11% following tracker pin placement in 13,217 robotic- and navigation-assisted TKA procedures. Although the article highlights an important and under-reported complication, three methodological concerns directly affecting the validity of these results warrant consideration: the aggregation of biomechanically distinct robotic and computer navigation systems; the absence of bone mineral density data, which is well-documented as the primary host-side risk factor for pin-site fractures; and the omission of platform-specific differences in pin geometry, cortical engagement protocol, and drilling technique. These concerns are intended to contextualize rather than diminish the scientific value of this first comprehensive pooled dataset.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.