Abstract

Robotic-assisted total knee arthroplasty (rTKA) has been suggested as a potential advancement over conventional total knee arthroplasty to improve surgical precision, functional recovery, and patient satisfaction. This review aimed to compare clinical and functional results of robotic-assisted versus conventional TKA in randomized controlled trials (RCTs), subgroup analysis according to short- and long-term follow-up. Systematic review and meta-analysis were conducted according to PRISMA guidelines. The following electronic data bases were utilized to search for qualified studies: MEDLINE/PubMed, Cochrane CENTRAL, Web of Science, ProQuest, ClinicalTrials.gov, grey literature, and Scopus. Only RCTs were included. Outcomes assessed were functional scores (Knee Injury and Osteoarthritis Outcome Score, Knee Society Score), range of motion (ROM), pain (visual analog scale), operation time, blood loss/transfusion, complications, length of stay in hospital, and readmission. Subgroup analysis was conducted according to short-term (≤1 year) and long-term (>1 year) follow-up. Robotic TKA demonstrated a significant improvement in functional score (MD 2.14; 95% CI 0.80-3.48; p = 0.002) and decrease in pain in long-term follow-up (MD-1.12; 95% CI-1.90-0.34; p = 0.005), but it showed no differences in range of motion, blood loss, complication, or hospitalization length of stay. Operative times were significantly longer with robotic TKA (MD 20.15 minutes; 95% CI 12.49-27.82; p < 0.00001). The rTKA offered minimal improvements in pain and function in the immediate postoperative and long-term follow-up relative to conventional TKA at a higher operative time. There was no significant improvement in ROM, blood loss, complications, or length of hospital stay for the rTKA.

Key words: Robotic-assisted total knee arthroplasty, conventional total knee arthroplasty, functional outcomes, long-term, short-term, systematic review