Effect of early hybrid assistive limb assisted rehabilitation on functional outcomes and patient satisfaction after total knee arthroplasty: a randomized controlled trial.

Only 68 patients were analysed after 7 of 75 assigned patients withdrew, so the study is small and may miss modest effects. Participants knew which group they were in, and the primary outcome was self-reported, so expectations could have influenced KOOS scores. The trial was done at one university hospital, with the same surgeons, implant and surgical approach, so it may not apply to other settings, patients, surgical techniques or implants. Follow-up stopped at 12 months, so it does not show whether the benefits last longer. No cost-benefit analysis was done, so the practicality and financial burden of HAL-SJ are unknown. All groups received the same rehabilitation, deep vein thrombosis prevention and pain management, and HAL-SJ was used approximately 7 times in both HAL-SJ groups, so the trial tests HAL-SJ timing within routine postoperative care rather than HAL-SJ alone or an optimal dose.

Do not conclude that HAL-SJ alone improves recovery after TKA. All groups received the same surgery, daily rehabilitation, deep vein thrombosis prevention and pain management, and the trial reported no significant between-group differences in quadriceps strength, walking speed or walking pain.