Comparison of Robotic-Assisted Versus Conventional Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.

INTRODUCTION Robotic-assisted total knee arthroplasty (RTKA) is an emerging alternative to conventional total knee arthroplasty (CTKA) with uncertain effectiveness. This systematic and meta-analysis aims to compare clinical and radiological outcomes between RTKA and CTKA.

Methods

52 studies were included (randomised controlled trials and observational cohorts). Outcomes compared were alignment (Hip-Knee-Ankle angle, femoral/tibial component angles), Patient Reported Outcome Measures (PROMs), operative time, length of stay (LOS), blood loss, and complications. Data were pooled using random-effect models, with heterogeneity assessed via I2 statistics using R.

Results

RTKA demonstrated superior accuracy in component alignment, and most PROMs showed minimal differences. Operative time was longer for RTKA, but hospital LOS was shorter. RTKA had lower blood loss. Inflammatory markers and revision rates showed few inconsistent findings.

Conclusion

RTKA improves mechanical alignment and reduces outliers, with modest short-term advantages in PROMs and recovery metrics. Long-term clinical benefits necessitate further high-quality studies with standardised outcome measures. TRIAL REGISTRATION This Systematic Review and Meta-Analysis was registered on PROSPERO (ID number: CRD42023410154).