Abstract
PURPOSE: Robotic knee replacement has gained widespread popularity globally, although the functional outcomes for patients, in comparison to traditional surgery, remain uncertain. This study aimed to compare patient-reported pain levels and early functional outcomes following robotic arm-assisted total knee arthroplasty (RTKA) and conventional jig-based TKA. The focus was on evaluating differences in pain relief, functional recovery, and postoperative scores at three, six, and 12 months. METHODS: A retrospective analysis was conducted on 240 patients with tri-compartmental osteoarthritis who underwent primary TKA between January 2021 and September 2022. Of these, 120 received RTKA, and 120 underwent conventional TKA. Patients were assessed preoperatively and postoperatively at three, six, and 12 months using the Western Ontario McMaster University Osteoarthritis Index (WOMAC), Hospital for Special Surgery (HSS) Knee Rating Scale, and Oxford Knee Score (OKS). Statistical analyses, including t-tests, Mann-Whitney U tests, and Friedman analysis of variance (ANOVA), were performed to compare differences in outcomes. RESULTS: Both the RTKA and conventional TKA groups exhibited significant functional improvements from baseline across all evaluated measures. When comparing absolute postoperative scores, there were no significant differences in WOMAC and OKS scores between the groups at three, six, and 12 months (p-values: 0.198, 0.206, and 0.446 for WOMAC; 0.465, 0.117, and 1.0 for OKS). However, the RTKA group had significantly higher HSS scores at 3 months (p = 0.032) and showed a significantly greater improvement in HSS from baseline at three months (p = 0.004) and in OKS from baseline at six months (p = 0.037). By 12 months, no notable differences in functional outcomes were observed between the groups. Patient satisfaction was high in both groups, with a trend toward greater satisfaction in the RTKA group regarding pain relief and daily activities. CONCLUSIONS: RTKA provided significant improvements in early functional outcomes, as evidenced by the higher HSS score at three months and the greater improvement in OKS at six months compared to baseline. However, by 12 months, no significant differences were observed between RTKA and conventional jig-based TKA in terms of functional outcomes and pain relief. These findings suggest that while robotic technology may enhance early recovery, its long-term benefits remain uncertain. Further research with extended follow-up periods especially in personalized alignment philosophies is necessary to evaluate the potential advantages of robotic assistance in long-term functional outcomes and implant longevity.