Short- and long-term outcomes of robotic versus conventional total knee arthroplasty: a systematic review and meta-analysis

Abstract

Robotic-assisted total knee arthroplasty (rTKA) has been suggested as a potential advancement over conventional total knee arthroplasty (cTKA) 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 databases were utilized to search for qualified studies: MEDLINE/PubMed, Cochrane CENTRAL, Web of Science, ProQuest, ClinicalTrials.gov, grey literature, and Scopus. Only randomized controlled trials were included. Outcomes assessed were functional scores (KOOS, KSS), range of motion (ROM), pain (VAS), 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 to 3.48; p≤ 0.002) and decrease in pain in long-term follow-up (MD-1.12; 95% CI-1.90 to-0.34; p≤0.005), but 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 robotic-assisted TKA 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 robotic-assisted TKA.