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Peer-reviewedCC BY-NC-ND 4.0Journal of Robotic Surgery

Understanding acceptance before intervention: patient perspectives on robotic-assisted femoral neck fracture fixation

  • Fawwaz Al-Smadi1
  • Xiayidan Abudourusuli2
  • Huidong Yang1
  • Sajeda Al-Smadi3
  • Jiewen Liao1
  • Lizhi Ouyang1
  • Zhenhe Zhang1
  • Ruiyin Zeng1
  • Bobin Mi1
  • Xudong Xie1
  • Mengfei Liu1
  • Guohui Liu1
  1. 1Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China
  2. 2Department of Public Administration, College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang China
  3. 3Pediatric Health Nursing, Department of Allied Medical Sciences, Zarqa University College, Al-Balqa Applied University, P.O. Box: 313, Zarqa, 13110 Jordan
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Abstract

Patient acceptance is important for surgical robotics implementation, but evidence in acute orthopaedic trauma is limited. We examined preoperative acceptance of robotic-assisted femoral neck fracture fixation and factors associated with behavioral intention. This prospective multicenter observational study included 378 adults with femoral neck fractures assessed before definitive fixation technique selection. A Chinese-adapted questionnaire assessed six acceptance constructs and behavioral intention. Multivariable linear regression with heteroskedasticity-consistent type 3 (HC3) robust standard errors examined associations with intention, while logistic regression assessed factors associated with post-introduction self-reported understanding of the robot’s role. Performance expectancy (B = 0.524; 95% CI, 0.391–0.657; P < 0.001), social influence (B = 0.262; 95% CI, 0.151–0.373; P < 0.001), and pleasure (B = 0.159; 95% CI, 0.038–0.281; P = 0.010) were associated with greater intention. In a separate contextual model, prior knowledge of femoral neck fracture surgical techniques (B = 0.905), self-reported understanding (B = 0.540), and robotic-option offering (B = 0.545) were positively associated with intention, whereas additional-cost concern was inversely associated (B = − 0.242). The association with robotic-option offering was not significant in a restricted-center analysis (B = 0.447; P = 0.125). Prior knowledge (aOR = 7.46; 95% CI, 4.01–13.89) and robotic-option offering (aOR = 2.54; 95% CI, 1.15–5.61) were associated with self-reported understanding. Acceptance of robotic-assisted femoral neck fixation reflects perceived technological value and the clinical decision context. Implementation should emphasize realistic expectations, clear explanations of the robot’s role, cost transparency, and informed patient choice.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11701-026-04155-1.

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Cite

BibTeXRIS
BibTeX
@article{alsmadi2026understanding,
  title = {{Understanding acceptance before intervention: patient perspectives on robotic-assisted femoral neck fracture fixation}},
  author = {Fawwaz Al-Smadi and Xiayidan Abudourusuli and Huidong Yang and Sajeda Al-Smadi and Jiewen Liao and Lizhi Ouyang and Zhenhe Zhang and Ruiyin Zeng and Bobin Mi and Xudong Xie and Mengfei Liu and Guohui Liu},
  journal = {Journal of Robotic Surgery},
  year = {2026},
  month = nov,
  doi = {10.1007/s11701-026-04155-1},
  url = {https://doi.org/10.1007/s11701-026-04155-1},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Understanding acceptance before intervention: patient perspectives on robotic-assisted femoral neck fracture fixation
AU  - Fawwaz Al-Smadi
AU  - Xiayidan Abudourusuli
AU  - Huidong Yang
AU  - Sajeda Al-Smadi
AU  - Jiewen Liao
AU  - Lizhi Ouyang
AU  - Zhenhe Zhang
AU  - Ruiyin Zeng
AU  - Bobin Mi
AU  - Xudong Xie
AU  - Mengfei Liu
AU  - Guohui Liu
PY  - 2026
DA  - 2026/11/07
JO  - Journal of Robotic Surgery
DO  - 10.1007/s11701-026-04155-1
UR  - https://doi.org/10.1007/s11701-026-04155-1
AB  - Patient acceptance is important for surgical robotics implementation, but evidence in acute orthopaedic trauma is limited. We examined preoperative acceptance of robotic-assisted femoral neck fracture fixation and factors associated with behavioral intention. This prospective multicenter observational study included 378 adults with femoral neck fractures assessed before definitive fixation technique selection. A Chinese-adapted questionnaire assessed six acceptance constructs and behavioral intention. Multivariable linear regression with heteroskedasticity-consistent type 3 (HC3) robust standard errors examined associations with intention, while logistic regression assessed factors associated with post-introduction self-reported understanding of the robot’s role. Performance expectancy (B = 0.524; 95% CI, 0.391–0.657; P < 0.001), social influence (B = 0.262; 95% CI, 0.151–0.373; P < 0.001), and pleasure (B = 0.159; 95% CI, 0.038–0.281; P = 0.010) were associated with greater intention. In a separate contextual model, prior knowledge of femoral neck fracture surgical techniques (B = 0.905), self-reported understanding (B = 0.540), and robotic-option offering (B = 0.545) were positively associated with intention, whereas additional-cost concern was inversely associated (B = − 0.242). The association with robotic-option offering was not significant in a restricted-center analysis (B = 0.447; P = 0.125). Prior knowledge (aOR = 7.46; 95% CI, 4.01–13.89) and robotic-option offering (aOR = 2.54; 95% CI, 1.15–5.61) were associated with self-reported understanding. Acceptance of robotic-assisted femoral neck fixation reflects perceived technological value and the clinical decision context. Implementation should emphasize realistic expectations, clear explanations of the robot’s role, cost transparency, and informed patient choice.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11701-026-04155-1.
SN  - 1863-2483
SN  - 1863-2491
ER  -