Conventional Vs. Robotic/Computer Assisted Total Knee Arthroplasty: A Meta-Analysis

# 1. INTRODUCTION The utility of robotics in total knee arthroplasty (TKA) remains controversial. This systematic literature review with a meta-analysis was performed to determine if robotics/computer assisted (RAS/CAS) TKA improved patient reported outcome measures (PROMs) compared to conventional TKA. # 2. MATERIALS AND METHODS A systematic literature search was performed for all studies comparing outcomes between Conventional and RAS/CAS TKA. Included studies directly compared RAS/CAS TKA and conventional TKA post-operative PROMs. Outcome measures included 2011 KSS, KSS, HSS, WOMAC, and OKS. Articles that did not directly compare RAS/CAS and conventional TKA and articles with Minors criteria \<12 were excluded. # 3. RESULTS Final analysis was performed on 22 studies which included 4009 TKAs with average follow-up of 52.9 months. 17 studies were evaluated for KSS scores, and moderate statistical heterogeneity was detected (τ 2 = 0.018; χ 2 = 28.29, df=16, p=0.03, I 2 =43). RAS/CAS TKA was favored over conventional TKA with a higher KSS score (SMD = 0.10; 95% CI: 0.0-0.21). 6 studies were evaluated for HSS scores and no statistical heterogeneity was detected (τ 2 = 0; χ 2 = 4.90, df=5, p=0.43, I 2 =0%), however RAS/CAS TKA was favored over conventional TKA with a higher HSS knee score (SMD = 0.31; 95% CI: 0.17-0.45). # 4. CONCLUSIONS This review shows that RAS/CAS TKA demonstrates promise in improving PROMs post-operatively compared to conventional TKA. However, it remains unclear how much these improvements translate to clinical impact. Continued analysis is warranted to further elucidate the impact of RAS/CAS on TKA.