Robot-Assisted Total Knee Arthroplasty Does Not Improve Long-Term Clinical and Radiologic Outcomes

Background Whether robot-assisted total knee arthroplasty (TKA) improves the accuracy of radiographic alignment leading to improved patient satisfaction and implant survivorship in the long term has thus far been inconclusive. Methods We retrospectively compared the long-term clinical and radiological outcomes of 84 knees that had undergone robot-assisted TKA using ROBODOC vs 79 knees that had undergone conventional TKA. The mean duration of the follow-up period was 129.1 months (range: 108-147 months). Clinical outcomes were evaluated using the Knee Society Score and 36-item Short Form Survey, as well as by assessing the range of motion, operation time, and complications. Radiologic outcomes were evaluated by assessing the hip-knee-ankle angle, coronal and sagittal alignments of the femoral and tibial components, and any radiologic abnormalities such as loosening or osteolysis. Results There was no significant difference in clinical outcomes between the two groups. The prevalence of an outlier for the hip-knee-ankle angle in the robot-assisted group was 10.7%, whereas it was 16.5% in the conventional group (P = .172). The other component alignments (α°, β°, γ°, δ°) revealed a tendency toward a lower rate of outliers in the robot-assisted group, but without statistical significance (P > .05). In addition, there was no significant difference in complications, including revision surgery, between both groups. Conclusion Robot-assisted TKA does not improve long-term clinical or radiologic outcomes compared with conventional TKA.