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Friday, August 21, 2026

Robotic assisted knee replacement gives the same patient outcomes as a surgeon only procedure

Robot-assisted knee replacement surgery is more precise than a surgeon on their own, but does not currently lead to improvements in patient outcomes

University of Warwick

Mako Robotic System in Use — image:
Mako robotic system in use. Credit: UHCW NHS Trust
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Credit: UHCW NHS Trust

Robot-assisted knee replacement surgery is more precise than a surgeon on their own, but does not currently lead to improvements in patient outcomes, according to the RACER-Knee trial, the world's largest clinical study of its kind. This trial makes an important contribution to the evidence on robotics in health care and where future advances and research should focus. The trial, coordinated by the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust, is published in The Lancet, the world's oldest and best-known general medical journal.

Robotic assistance is increasingly used in knee replacement surgery worldwide, in six per cent of procedures in the UK, compared with 16 per cent in the US and 42 per cent in Australia, with the aim of helping surgeons place the knee replacement more precisely and tailoring surgery to a patient’s anatomy.

The National Institute for Health and Care Research (NIHR) funded the UK-wide RACER-Knee trial in partnership with Stryker, who make the robot that was tested. It was led by the Warwick Clinical Trials Unit, UHCW NHS Trust and the Royal Orthopaedic Hospital in Birmingham. It is the world's largest double-blinded randomised control trial comparing conventional total knee replacement to surgery assisted with the Stryker Mako robotic system, the most widely used system globally.

The trial found that one year after surgery, patients in both groups had similar recovery, mobility and pain levels. While robotic assistance was more precise, it did not translate into improvements in patient outcomes within the first year after knee replacement. The trial also found that robot-assisted knee replacement was not linked to an increased risk of serious adverse events, suggesting it was as safe as the usual approach to surgery.

The study was led between two Chief Investigators in the UK, they said:

Professor Andrew Metcalfe, Warwick Medical School, University of Warwick, and Consultant Orthopaedic Surgeon at UHCW NHS Trust: “We are delighted to have completed this world-leading randomised trial of an exciting technology that is now being used globally and at scale. It is an important step in the process of innovation and will stimulate lots more high-quality studies. We are very grateful for the support of the many patients who took part which is so important, but also the NIHR and Stryker for working so well together to support this critical study. Technology such as this could really help the care we give for patients, but for robotic-assisted knee replacements, there is still work to do before we see benefits such as less pain or better movement.”

Professor Edward Davis, Consultant orthopaedic surgeon at The Royal Orthopaedic Hospital NHS Foundation Trust and Honorary Professor at University of Birmingham: “The trial demonstrates robotic-arm-assistance allows for higher precision, and in theory the system should allow surgeons to customise the procedure according to a patient’s anatomy. These results are by no means a condemnation of the robotic systems, but more understanding of the ideal position for a knee replacement and personalisation for each patient is needed. We’ll then be able to truly take advantage of the advanced precision of robotic systems. “

Professor Anthony Gordon, Director for the NIHR Health Technology Assessment (HTA) Programme, said: “Innovation in healthcare depends on evaluating promising technologies rigorously and at scale. While this study shows robotic-assisted knee replacement is not yet improving patient outcomes, it highlights opportunities to refine these technologies and harness their precision to deliver better care in the future. The NIHR continues to fund robust studies, such as RACER, ensuring we learn how to deliver the latest technologies most effectively within the NHS.”

Total knee replacement is one of the most common elective operations worldwide for treating knee arthritis. Conventionally, surgeons rely on their experience and a standard set of instruments to perform the procedure. Some surgeons now use a robotic arm, controlled by the surgeon, to assist in the operation. The system positions instruments with high precision and gives surgeons greater flexibility to vary cutting angles and depths, enabling personalised approaches tailored to individual patient’s anatomy in ways conventional surgery cannot achieve.

339 patients from 10 hospitals, under the care of 33 surgeons across the UK, took part in the trial. Despite the potential advantages of robotics, the trial found that there was no meaningful difference in the primary measure, the Forgotten Joint Score, 12 months after the operation. The score measures the extent to which patients are aware of their artificial joints during daily activities, and patients showed equal results with their artificial joints, whichever method was used for doing the replacement. Patients also showed comparable outcomes in their ability to walk, their experience of pain in the first three months and at 12 months, their pain in hospital, and the likelihood of a follow-up operation.

The researchers will continue to follow-up patients for ten years to find out if there are any long-term differences between the two approaches. Importantly this might find out if there is a difference in number or patients needing more surgery for their knee.

Robotic TKRs took longer to perform (on average 10.5 minutes) and were around £950 more expensive on average, but were more precise and were not associated with an increased risk of serious adverse events, suggesting the robotic procedure was as safe as conventional surgery. Under current NHS cost limits, the robotic system tested in this trial was not cost-effective over the first year after surgery.

In the future, if the use of robotic assistance could help surgeons to better tailor to each patient's individual anatomy, then the robotic system's better precision could become worthwhile. This would need more development and further research but is an exciting area for future studies.

ENDS

The results of the RACER-Knee trial have published in The Lancet. DOI: 10.1016/S0140-6736(26)00986-4

Notes to Editors

For more information please contact:

Matt Higgs, PhD | Media & Communications Manager (Warwick Press Office)

Email: Matt.Higgs@warwick.ac.uk | Phone: +44(0)7880 175403

About the Trial

This research has been organised by University Hospitals Coventry and Warwickshire NHS Trust, and the University of Warwick. It has been funded by the UK NHS research body, the National Institute for Health Research, through its Health Technology Assessment Programme (NIHR128768)

Stryker, the manufacturers of the robotic system, met the additional costs of doing robotic surgery within this study. They were not involved in the analysis or interpretation of the study findings.

About the University of Warwick

Founded in 1965, the University of Warwick is a world-leading institution known for its commitment to era-defining innovation across research and education. A connected ecosystem of staff, students and alumni, the University fosters transformative learning, interdisciplinary collaboration, and bold industry partnerships across state-of-the-art facilities in the UK and global satellite hubs. Here, spirited thinkers push boundaries, experiment, and challenge convention to create a better world.

About University Hospitals Coventry and Warwickshire NHS Trust

University Hospitals Coventry and Warwickshire NHS Trust (UHCW) are one of the largest acute teaching Trusts in the UK, comprising University Hospital in Coventry and the Hospital of St Cross in Rugby and working in partnership with Warwick University Medical School and Coventry University. It has more than 11,000 staff and delivers services across the West Midlands region. This includes hosting region-wide services such as the Coventry and Warwickshire Pathology Network and Bowel Cancer Screening programme. The Trust works closely with its partners in health and social care in Coventry and Warwickshire to develop patient-focused services that meet the needs of our communities.

About the Royal Orthopaedic Hospital NHS Foundation Trust

The Royal Orthopaedic Hospital NHS Foundation Trust is one of the largest specialist orthopaedic units in Europe, offering planned orthopaedic surgery to people locally, nationally, and internationally. The Trust is an accredited Veteran Aware organisation and a Disability Confident Leader. A national centre for bone cancer and musculoskeletal medicine, the Royal Orthopaedic Hospital has a vibrant research portfolio of clinical trials, observational studies and laboratory studies exploring new treatment options, new approaches in rehabilitation and therapy, and new medical devices. This research is delivered by our researchers and clinicians spread across the Knowledge Hub, our home for education and research, and the Dubrowsky Regenerative Medicine Laboratory.

About NIHR

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research.

We do this by:

funding high quality, timely research that benefits the NHS, public health and social care
investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
attracting, training and supporting the best researchers to tackle complex health and social care challenges
collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
funding applied global health research and training to meet the needs of the poorest people in low- and middle-income countries

NIHR is funded by the Department of Health and Social Care.

Our work in low- and middle-income countries is principally funded through UK international development funding from the UK government.

Journal

The Lancet

DOI

10.1016/S0140-6736(26)00986-4

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Robotic-arm-assisted versus conventional total knee replacement (RACER-Knee): a pragmatic, multicentre, participant-masked and assessor-masked, superiority, randomised controlled trial

Article Publication Date

20-Aug-2026

Mako system being prepped for surgery. Credit: UHCW NHS Trust

Mako robotic system assisted surgery. Credit: UHCW NHS Trust

COI Statement

JM, SF, DD, and DE report funding from the UK National Institute for Health and Care Research (NIHR) for this study. AM reports a NIHR grant to institution and Stryker benefit in kind for this study; is chief or co-investigator on two other studies with NIHR grants to institution and Stryker benefit in kind; reports further NIHR grants; has received payment for expert testimony for the UK COVID Inquiry; is Director and Chief Medical Officer of VerIQ; is Secretary for the British Patellofemoral Society; was research lead of the British Association of Surgery for the Knee; is on a clinical advisory board for Sagence; and holds stock in VerIQ and Sagence. AT reports research grants from Stryker Masters Services Framework research agreement, NIHR, and Versus Arthritis; royalties from Corin; and consulting fees and payment for presentations from Stryker, Corin, Adler, and Quadsense. CS reports research grants from Stryker; consulting fees from Stryker, Smith & Nephew, and Osstec; payment for lectures from Zimmer Biomet; was a member of a Data Safety and Monitoring Board and an advisory board for Smith & Nephew; is Editor in Chief for Bone & Joint Research; and is on the editorial board of The Bone & Joint Journal. CK reports a salary from the RACER-Knee grant and Stryker benefit in kind for this study. ED reports an NIHR grant and Stryker excess treatment costs for this study; research funding from Smith & Nephew and Stryker to institution; royalties from Smith & Nephew and Microport; consulting fees from Smith & Nephew, Microport, and Garland Surgical; payment for lectures from Smith & Nephew, Stryker, and Microport; payment as an expert witness for Irwin Fritchie Urquhart Moore & Daniels and Hogan Lovells International; financial support for attending meetings from Smith & Nephew, Stryker, Zimmer Biomet, and Microport; holds shares in VerIQ and Garland Surgical; and is the Director of Precision Joint Replacement. FH reports an NIHR grant for this study; research grants from the NIHR, Stryker, Smith & Nephew, Corin, and the International Olympic Committee; royalties or licenses from Smith & Nephew, Stryker, Corin, MatOrtho, and Springer; consulting fees for Stryker; payments for lectures and presentations from Stryker, Zimmer Biomet, and AO Recon; financial support for travel from Stryker, Zimmer Biomet, AO Recon, and The Bone & Joint Journal; is a member of The Bone & Joint Journal editorial board; is President of the International Hip Society; is President of the European Hip Society; and is an International Society for Technology in Arthroplasty board member. HP reports an NIHR grant to institution and Stryker benefit in kind for this study; research grants from the NIHR; and participated in three independent oversight committees for NIHR-funded studies. MU reports an NIHR grant to institution and Stryker funding to the UK National Health Service for this study; grants from the NIHR, Norwegian Medical Research Council, and Australian National Health and Medical Research Council; royalties from the University of Warwick; accepted travel and accommodation costs as an invited speaker on back pain, at UK scientific meetings from the British Pain Society and the Society for Back Pain Research; participated in a Data Safety and Monitoring Board for the NIHR; is a director at and shareholder in Clinvivo; and declares that Stryker has supplied clinical materials for another ongoing and one completed randomised controlled trial, both funded by the NIHR. NCl reports funding from Stryker for other research grants not related to this manuscript; and is an editorial board member of The Bone & Joint Journal and Bone & Joint Research. All other authors declare no competing interests.

Thursday, August 20, 2026

Alarming study reveals that almost 40 per cent of music released globally in July 2026 used AI

By David Mouriquand

Published on 20/08/2026 - EURONEWS

The use of AI in music creation continues to be a divisive topic and recent figures confirm that the onslaught of AI-generated tracks is not slowing down. Worse, certain artists are becoming more open about using the controversial technology.

“Just stop your crying, it's a sign of the times...”

What do you know about it, Harry Styles? Some signs are worth crying over.

Here’s one that is sure to provoke some sobbing: As AI-generated music continues to flood streaming platforms, a new study has revealed that almost 40 per cent of new music released globally in July 2026 used AI in its creation.

That alarming figure comes from a new survey by SubmitHub, an online platform that allows users to submit music to playlists and blogs. They analysed over a million pieces of music and using their own AI detector, SH Labs, found that 23.2 per cent of them were fully AI-generated.

In addition to that, 15.3 per cent were found to have used elements of AI-generated audio that had been "modified or processed" by humans. That totals to a whopping 38.5 per cent of all music released last month to have been made with the involvement of AI.

SubmitHub was launched SH Labs earlier this summer in order to highlight a “growing disclosure problem” with artificial intelligence in music. Their AI detection tool is being used by Bandcamp and Traxsource to uncover the use of AI in music, as well as GEMA, the performance rights organisation which recently won a landmark court case against AI music generator platform Suno.

In a statement, SubmitHub’s founder Jason Grishkoff said: "I think the path forward for AI music is disclosure. People should be able to decide for themselves whether they want to engage with AI-generated music.”

He added: “Our job is to give them enough information to make that choice."

These recent figures follow fresh stats from Deezer, who reported that AI tracks accounted for more than half of all new daily uploads in June. They also follow a 2025 study that found that 97 per cent of people “can’t tell the difference between real and AI music”.

Certain organisations are starting to finally wake up to the concerns of real artists and music lovers expressing concerns over the AI slop dished out on streaming platforms.

For instance, Bandcamp banned all AI-created music at the start of 2026, stating that they “reserve the right to remove any music on suspicion of being AI-generated", while streaming giant Spotify recently announced that it will begin adding an “AI Persona” badge to some artist profiles, helping listeners identify when an artist’s music may have been generated using artificial intelligence. That initiative starts in September.

While artists from Kate Bush to Queen’s Brian May have spoken out on the existential crisis AI represents to creatives, stating that “the unlicensed use of creative works for training generative AI is a major, unjust threat to the livelihoods of the people behind those works”, there are some creatives who have taken a more decomplexed approach to the use of the controversial technology.

Empire Of The Sun’s Luke Steele recently admitted that he uses AI to make music; Boy George said he used AI to help write his dire pro-Israel reggae track ‘We Will Dance Again’ (something which eventually led it to be removed from Bandcamp for violating its AI rules); and one recent artist who has provoked the ire of his peers is American rapper Tyga.

The latter admitted he used AI as a “tool” on his new (and critically panned) album, ‘$tarface’. Tyga used AI to generate the retro synths on his album, framing it the “tool” as being “no different than when Auto-Tune came out.”

Regardless, the album has been savaged by critics, with Pitchfork giving it the lowest possible rating of 0/10, describing ‘$tarface’ as “smug and complacent and depressing” and that “its very existence has made the world a worse place.”

Artists have called out Tyga – including Doja Cat, who spoke for many music lovers when she called him a “penis for making an AI album”.

A literal and figurative tool for some; a complete scam for others.

In a further sign that certain content creators are becoming more comfortable / shameless in embracing AI slop, American record prodcuer and rapper Timbaland has launched an “A-Pop” venture called Stage Zero and signed its first act, TaTa, which he describes as “a living, learning, autonomous music artist built with AI.”

These examples and recent figures, on top of the harrowing “music” by AI creations Tilly Norwood, Velvet Sundown and Breaking Rust - who compete with real artists for listening time as well as royalties - show that one thing is clear. We’re not out of the artificial woods yet.

Wednesday, August 19, 2026

Shakira and Warren Buffett's son announce rebuilding of schools in Chocó

By Javier Iniguez De Onzono

Published on 18/08/2026 - EURONEWS

The Colombian singer will not donate the announced one million dollars directly; it will be channelled via Global Citizen and promoter Live Nation, in which she is involved.

Shakira announced on Monday that she will mobilise funding to rebuild the Technological University of Chocó, damaged by the earthquake that struck Colombia on 10 August, as well as around ten non-university educational centres in one of the five departments worst affected by the quake.

The Barranquilla-born artist's donation will not be made directly. The philanthropic organisation Global Citizen will contribute 500,000 dollars (€432,250) and the concert promoter Live Nation, which organised her latest tour, 'Las Mujeres Ya No Lloran', and is also her commercial partner, will provide a further 500,000 at her instigation.

In October 2025 Shakira joined the advisory board of the education fund that FIFA runs with Global Citizen, alongside Serena Williams, The Weeknd and FIFA's own president, the embattled Gianni Infantino. This came several months before her participation as a performer at the recent 2026 World Cup was announced. The Barranquilla-born singer says she has allocated 100% of the royalties generated by the tournament's official song, 'Dai Dai', to that fund.

Shakira will work with Colombian-American philanthropist Howard Graham Buffett, son of tycoon Warren Buffett, one of the world's richest men thanks to multi-billion-dollar stakes in companies such as Apple, Coca-Cola and American Express.

The middle son of the billionaire obtained Colombian citizenship in 2021, under the government of Iván Duque, after investing more than 160 million dollars in projects in the Catatumbo region, including the rebuilding of roads, the replacement of illicit crops and demining work.

"Howard is going to help us, through [the Pies Descalzos Foundation], to build ten new schools in Chocó; that's why it was so important to bring him, that's why it was so important to come today," Shakira told reporters during a visit with Buffett to Quibdó, the capital of Chocó. Buffett's son has overseen Pies Descalzos for two decades; a foundation that has already taken part in the construction of several educational institutions in Colombia.

The visit comes a week after the earthquake, whose epicentre was in San José del Palmar but which affected departments such as Valle del Cauca and Risaralda. The quake has so far left 287 dead, 4,147 injured and 194 missing, according to the latest figures from the National Unit for Disaster Risk Management (UNGRD).

Monday, August 17, 2026

Scientists identify brain’s brake that shuts off chronic pain

Finding from mouse study could lead to targeted treatments for chronic nerve pain

WashU Medicine

locus coeruleus — image:
A cluster of nerve cells (cyan, right) in the mouse brain (cyan, left) play a role in both pain relief and the generation of chronic pain. WashU Medicine researchers found that certain receptors on the surface of these cells can shut off chronic pain.
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Credit: Chao-Cheng Kuo

Deep at the base of the brain, a tiny cluster of nerve cells serves as the body’s natural pain reliever, dialing down pain signals traveling up the spinal cord. But nerve damage can flip this system into a hyperactive engine for chronic pain.

Now, researchers at Washington University School of Medicine in St. Louis have figured out why that switch flips, and how to shut it off. They identified, in mice, that certain receptors that reside on the surface of cells in the brain’s main alert and stress center act as biological brakes on pain. Previously known to influence stress in this region of the brain, these receptors also can turn off the pain engine to relieve chronic neuropathic pain following nerve injury.

The study, published Aug. 17 in Current Biology, opens new doors for developing therapies that specifically target this region of the brain, known as the locus coeruleus, to reduce chronic pain.

“Millions of adults live with chronic neuropathic pain caused by nerve damage,” said Jordan McCall, PhD, an associate professor in the Center for Clinical Pharmacology in the WashU Medicine Department of Anesthesiology and the study’s senior author. “The pain is difficult to treat, and traditional opioid medications bind to receptors throughout the entire body and brain, often leading to side effects, tolerance and addiction risk. Understanding how localized receptors in the locus coeruleus act as gatekeepers could lead to more targeted, effective pain therapies with fewer risks.”

A brake on pain

Neuropathic pain occurs when damaged nerve fibers send relentless, misfired signals to the brain, causing shooting, stabbing or burning sensations. The condition frequently stems from diabetes, viral infections or nerve compression, among other factors.

To understand how to stop these signals, McCall’s team, including co-first authors Chao-Cheng Kuo, PhD, a postdoctoral research associate, and Makenzie R. Norris, a former graduate student, focused on the locus coeruleus, a part of the brain that has been shown to play a role in pain regulation.

First, they confirmed that nerve injury turns this region into an active driver of pain. When they temporarily turned off locus coeruleus brain cells in mice, they observed reduced sensitivity to touch and heat among animals modeling neuropathic pain compared with healthy mice.

Next, they turned their attention to receptors on locus coeruleus brain cells that respond to opioids, and in particular, a type of opioid receptor known as mu. Mu opioid receptors are scattered throughout the brain and spinal cord. When the body’s naturally produced opioids or synthetic ones such as morphine and fentanyl land in the receptors’ pockets, pain throughout the nervous system lessens. Because the locus coeruleus is packed with these receptors, the researchers wondered if they play an important role in pain regulation.

They deleted the mu opioid receptors on only the locus coeruleus brain cells in mice with neuropathic pain. Without the receptors, the mice were even more sensitive to touch and heat compared with mice with mu opioid receptors still present in the locus coeruleus. Restoring the receptors to those same neurons reversed the hypersensitivity, effectively turning the pain off.

The result indicates that chronic pain may be impairing the ability of mu opioid receptors to tamp down the activity of brain cells in the locus coeruleus. Building on these findings, the researchers are exploring how to manipulate the locus coeruleus without affecting receptors across the rest of the nervous system. By designing therapies that specifically engage mu opioid receptors in this brain region, the researchers said they hope to pave the way for treatments that offer powerful relief for chronic neuropathic pain.

Kuo CC, Norris MR, Dunn SS, Becker LJ, Kim JR, Vazquez CR, Borges G, Thang LV, O’Brien JT, Parker KE, McCall JG. Mu opioid receptors gate the locus coeruleus pain generator. August 17, 2026. Current Biology.

This work was funded by the National Institutes of Health, grant numbers R01NS117899, R01NS135401, F31NS124301 and F31DA065440; the National Science Foundation, grant number DGE-2139839; the McDonnell Center for Systems Neuroscience; a Collaboration Support initiative for Translational Anesthesiology Research (COSTAR) award from the Department of Anesthesiology at Washington University School of Medicine; and the Rita Allen Foundation with added financial help from the Open Philanthropy Project. The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH.