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Comparison of Robotic-Assisted Versus Conventional Total Knee Arthroplasty: A Systematic Review and Meta-Analysis
Abdulazeez Omairi1, Ryan Kenny2,3, Oday Al-Dadah1,4
1Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, UK.
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).