Complications Of Robotic Assisted Total Knee Arthroplasty Vs Manual Total Knee Arthroplasty: A Systematic Review And Meta-Analysis

Abstract

Introduction: Robot-assisted total knee arthroplasty (rTKA) is rapidly emerging as a superior technique in orthopaedic surgery, and its popularity continues to grow. The variations between robotic-assisted and manual TKA can significantly affect the likelihood of various complications. Goals: This study aims to compare the complications associated with robotic-assisted total knee arthroplasty (rTKA) and manual total knee arthroplasty (mTKA). Methods: A systematic review and meta-analysis were conducted and searches of PubMed, MEDLINE, and ScienceDirect were performed in October 2024. The review included observational studies only. There were 911 articles identified, following full text screening, 8 studies satisfied the inclusion criteria. Postoperative complications such as periprostetic joint infection, periprostetic fractures, arthrofibrosis, operative times, and blood loss were analyzed. Result: The meta-analysis demonstrated a lower risk of postoperative knee stiffness in the rTKA group compared to the mTKA group (RR = 0.57, 95% CI [0.48–0.68], p < 0.00001). Other complications such as aseptic loosening (RR = 0.98, 95% CI [0.52, 1.84], p = 0.95), periprosthetic fractures (RR = 0.73, 95% CI [0.25, 2.13], p = 0.57), and periprosthetic joint infection (RR = 0.76, 95% CI [0.56, 1.02], p = 0.07) showed no statistically significant differences between each group. Conclusion: The findings of this study indicate that rTKA is associated with a reduced risk of knee stiffness compared to mTKA. Additionally, the incidence of complications following rTKA and mTKA is comparable, with both procedures exhibiting a low complication rate.