Patient-reported outcomes are comparable between imageless robotic-assisted and computer-navigated total knee arthroplasty

A recent retrospective cohort study, conducted by Jacob O’Brien, David Parker, Pradyumna Raval, Harbeer Ahedi, and Myles Coolican, and recently published in the latest edition of the KSSTA Journal, directly compared patient-reported outcomes (PROMs) following imageless robotic-assisted total knee arthroplasty (RA-TKA) versus computer-navigated TKA (CN-TKA), addressing a key question as RA-TKA adoption continues to grow. https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.70266

The study included 399 patients undergoing primary TKA for osteoarthritis between December 2021 and April 2023 (RA-TKA: n=212; CN-TKA: n=187), with PROMs collected preoperatively, at 3 months, and at 12 months. Measures included the Oxford Knee Score (OKS), Forgotten Joint Score (FJS), Veterans Rand 12-item mental and physical health surveys (VR-12), pain (VAS), and patient satisfaction.

At 12 months, no significant differences were observed in key PROMs (OKS and FJS) between RA-TKA and CN-TKA. Patient satisfaction showed a modest advantage for CN-TKA (adjusted mean difference: –3.94; 95% CI: –7.44, –0.45). Within the RA-TKA cohort, CORI systems were associated with slightly higher subjective knee normality than ROSA (adjusted mean difference: –8.44; 95% CI: –16.0, –0.90), but no other meaningful differences were identified.

For orthopaedic surgeons, these findings indicate that well-executed CN-TKA continues to deliver comparable PROMs to imageless robotic techniques at 12 months. While RA-TKA may offer other intraoperative benefits, such as workflow standardisation or precision, the current evidence does not support transitioning from established CN-TKA solely for short-term PROM improvement. Surgeons considering RA-TKA adoption should balance these findings against costs, training requirements, and institutional resources, and continue to monitor emerging long-term data to guide practice evolution.