Robotic-Assisted versus Conventional Manual Total Knee Arthroplasty: A Systematic Review of Radiographic and Clinical Outcomes

Abstract

Introduction: Robotic-assisted total knee arthroplasty (TKA) aims to improve the accuracy of implant positioning and limb alignment compared to conventional manual techniques. This review evaluates whether this technological advantage translates into better clinical outcomes.

Methods: A search of MEDLINE and Embase was conducted for RCTs comparing robotic-assisted TKA to conventional TKA. Primary outcomes were radiographic accuracy (implant alignment) and short-term functional scores (e.g., Knee Society Score, WOMAC).

Results: The meta-analysis of 22 RCTs demonstrated that robotic-assisted TKA resulted in significantly more accurate implant placement and a lower proportion of alignment outliers compared to conventional methods. Some studies reported small but statistically significant improvements in early functional outcomes and reduced pain.

Discussion: Robotic assistance reliably improves the precision of TKA implantation. While the impact on short-term functional outcomes is modest, the long-term effect of improved alignment on implant survivorship is a key area for future research.

Conclusion: Robotic-assisted TKA improves radiographic accuracy compared to conventional techniques, with potential for modest early functional benefits.