Publication:

Effectiveness and safety of robotic-assisted total knee arthroplasty versus conventional manual technique: a systematic review focusing on clinical and functional outcomes

Robotic-assisted total knee arthroplasty (RA-TKA) improve surgical precision over conventional manual TKA (CM-TKA). This review discussed their clinical and functional outcomes and safety. A PRISMA-compliant systematic review of comparative studies from multiple databases up to October 2024. Data were pooled for key outcomes. RA-TKA significantly reduced mechanical alignment outliers (RR=0.33, 95% CI 0.19-0.59) and mean deviation from neutral axis (MD=-0.93°). Operative time was longer for RA-TKA (MD=+19.94 minutes). Analysis of patient-reported outcomes showed a statistically significant but clinically insignificant improvement in Knee Society Score (MD=+1.03 points). No significant differences were found in WOMAC, Oxford Knee Scores or overall complication and revision rates. However, RA-TKA was associated with a higher Forgotten Joint Score at 1, 2, and 5 years and improved early gait stability. Some cohorts reported shorter hospital stays and higher patient satisfaction (95.0% vs. 87.4%) with robotics. Registry data confirmed no reduction in early revision risk. RA-TKA provides superior alignment but no consistent functional superiority or safety advantage over CM-TKA.