Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis
ABSTRACT Background and Objectives Total knee arthroplasty (TKA) is a standard treatment for end‐stage knee osteoarthritis (KOA). While conventional TKA (cTKA) is widely used, robotic‐assisted TKA (rTKA) has gained attention for its potential precision and improved outcomes. However, the comparative...
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| Format: | Article |
| Language: | English |
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Wiley
2025-06-01
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| Series: | Orthopaedic Surgery |
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| Online Access: | https://doi.org/10.1111/os.70007 |
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| author | Han‐Yang Yue Guo‐Qiang Ding Hua‐Xin Li Jun Zeng Xiao‐Dan Jiang Zong‐Dong Zhu Hua Jiang |
| author_facet | Han‐Yang Yue Guo‐Qiang Ding Hua‐Xin Li Jun Zeng Xiao‐Dan Jiang Zong‐Dong Zhu Hua Jiang |
| author_sort | Han‐Yang Yue |
| collection | DOAJ |
| description | ABSTRACT Background and Objectives Total knee arthroplasty (TKA) is a standard treatment for end‐stage knee osteoarthritis (KOA). While conventional TKA (cTKA) is widely used, robotic‐assisted TKA (rTKA) has gained attention for its potential precision and improved outcomes. However, the comparative efficacy and safety of rTKA versus cTKA remain unclear due to inconsistent findings in existing studies. This study aims to systematically review and compare the efficacy and safety of rTKA and cTKA in patients with KOA. Methods A total of seven databases were searched. Only randomized controlled trials (RCTs) were included in this systematic review. Subgroup analysis, sensitivity analysis, and trial sequential analysis (TSA) were used to evaluate the stability of the results. Results Twenty‐five RCTs involving 3156 patients with KOA were included. The only statistically significant clinical difference between patients who received rTKA and cTKA was that the rTKA group was associated with a longer operative duration (MD = 22.38 mins; 95% confidence interval [CI] [12.86, 31.91]; p < 0.00001; I 2 = 98%). As for functional parameters, the two groups had similar results in postoperative Knee Society Score (KSS), the Western Ontario and McMaster Universities (WOMAC), and Hospital for Special Surgery Score (HSS). Regarding the tibiofemoral angle and the coronal femoral component angle, no significant difference was observed between the two groups. Patients in the rTKA group had a higher hip–knee–ankle angle (HKA) (MD = 0.63; 95% CI [0.23, 1.03]; p = 0.002; I 2 = 52%), lower HKA deviation (MD = −0.99; 95% CI [−1.24, −0.74]; p < 0.00001; I 2 = 0%), and a higher coronal tibial component angle (MD = 0.46; 95% CI [0.07, 0.85]; p = 0.02; I 2 = 81%) after the surgery. Conclusions While rTKA appears to be a feasible and safe alternative to cTKA, the mixed evidence from our study highlights the need for further research to fully understand its clinical implications and long‐term outcomes. Trial Registration: PROEPERO: CRD42024541052 |
| format | Article |
| id | doaj-art-c7772bedfc2b4e7cbfeeab1a088c2ddc |
| institution | DOAJ |
| issn | 1757-7853 1757-7861 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj-art-c7772bedfc2b4e7cbfeeab1a088c2ddc2025-08-20T03:09:57ZengWileyOrthopaedic Surgery1757-78531757-78612025-06-011761549156010.1111/os.70007Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐AnalysisHan‐Yang Yue0Guo‐Qiang Ding1Hua‐Xin Li2Jun Zeng3Xiao‐Dan Jiang4Zong‐Dong Zhu5Hua Jiang6Institute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Orthopedics, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaInstitute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaInstitute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaInstitute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaDepartment of Orthopedics, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaInstitute for Emergency and Disaster Medicine, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, School of Medicine University of Electronic Science and Technology of China Chengdu ChinaABSTRACT Background and Objectives Total knee arthroplasty (TKA) is a standard treatment for end‐stage knee osteoarthritis (KOA). While conventional TKA (cTKA) is widely used, robotic‐assisted TKA (rTKA) has gained attention for its potential precision and improved outcomes. However, the comparative efficacy and safety of rTKA versus cTKA remain unclear due to inconsistent findings in existing studies. This study aims to systematically review and compare the efficacy and safety of rTKA and cTKA in patients with KOA. Methods A total of seven databases were searched. Only randomized controlled trials (RCTs) were included in this systematic review. Subgroup analysis, sensitivity analysis, and trial sequential analysis (TSA) were used to evaluate the stability of the results. Results Twenty‐five RCTs involving 3156 patients with KOA were included. The only statistically significant clinical difference between patients who received rTKA and cTKA was that the rTKA group was associated with a longer operative duration (MD = 22.38 mins; 95% confidence interval [CI] [12.86, 31.91]; p < 0.00001; I 2 = 98%). As for functional parameters, the two groups had similar results in postoperative Knee Society Score (KSS), the Western Ontario and McMaster Universities (WOMAC), and Hospital for Special Surgery Score (HSS). Regarding the tibiofemoral angle and the coronal femoral component angle, no significant difference was observed between the two groups. Patients in the rTKA group had a higher hip–knee–ankle angle (HKA) (MD = 0.63; 95% CI [0.23, 1.03]; p = 0.002; I 2 = 52%), lower HKA deviation (MD = −0.99; 95% CI [−1.24, −0.74]; p < 0.00001; I 2 = 0%), and a higher coronal tibial component angle (MD = 0.46; 95% CI [0.07, 0.85]; p = 0.02; I 2 = 81%) after the surgery. Conclusions While rTKA appears to be a feasible and safe alternative to cTKA, the mixed evidence from our study highlights the need for further research to fully understand its clinical implications and long‐term outcomes. Trial Registration: PROEPERO: CRD42024541052https://doi.org/10.1111/os.70007conventional total knee arthroplastyknee osteoarthritisrobot‐assisted total knee arthroplastyTKA |
| spellingShingle | Han‐Yang Yue Guo‐Qiang Ding Hua‐Xin Li Jun Zeng Xiao‐Dan Jiang Zong‐Dong Zhu Hua Jiang Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis Orthopaedic Surgery conventional total knee arthroplasty knee osteoarthritis robot‐assisted total knee arthroplasty TKA |
| title | Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis |
| title_full | Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis |
| title_fullStr | Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis |
| title_full_unstemmed | Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis |
| title_short | Does Robotic‐Assisted Total Knee Arthroplasty Improve Outcomes of Adult Osteoarthritis Patients—A Systematic Review and Trial Sequential Meta‐Analysis |
| title_sort | does robotic assisted total knee arthroplasty improve outcomes of adult osteoarthritis patients a systematic review and trial sequential meta analysis |
| topic | conventional total knee arthroplasty knee osteoarthritis robot‐assisted total knee arthroplasty TKA |
| url | https://doi.org/10.1111/os.70007 |
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