Journal of Orthopaedic Surgery and Research · IF 2.8 · September 9, 2026 · LoE I
Robotic-assisted versus conventional total knee arthroplasty: an updated systematic review and meta-analysis of randomized controlled trials with grade assessment
Moayad Mosleh, Ahmed Eldesouky, Mohamedhen Vall Nounou, Mohammed Bahlol, Nuran Arif Benfaid, Tobias Renkawitz, Amr Al Hammoud, Ahmed Benali, Omnia Rehal, Muhammed K. Elhadi — Syrian Virtual University
This is a meta-analysis of 31 randomized trials (4086 patients) comparing robotic-assisted total knee arthroplasty (RTKA) to conventional TKA. RTKA modestly improved several radiographic alignment measures, most notably reducing hip-knee-ankle deviation by 0.83 degrees and cutting the rate of alignment outliers roughly in half, but patient-reported function, pain, biomarkers, blood loss, hospital stay, and overall complications were largely similar between groups, while robotic surgery took about 21 minutes longer on average.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersRTKA is being rapidly adopted based on the promise of better alignment, so trainees should know that improved radiographic precision has not yet reliably translated into better patient-reported outcomes.
Conclusion strengthConfirms prior evidence
How many patients this affects and prospectively registered, offset by no correction for multiple comparisons and requires equipment most centres do not have.
Presenting this at rounds? Start here
- ?If radiographic alignment improves with robotic assistance but patient-reported function does not, how should this change how you counsel patients about choosing RTKA versus conventional TKA?
- ?Given that RTKA adds about 20 minutes of operative time without clear functional benefit, how should surgeon experience, case complexity, and institutional resources factor into deciding which patients are best suited for robotic assistance?