Introduction: There is limited data available on short-term outcomes on a cut-block positioning robotic system. The purpose of this study was to compare 12-month clinical outcomes between robotic-assisted (raTKA) and conventional total knee arthroplasty (cTKA) with multiple outcomes and surgical centers.

Methods: This was a non-randomized controlled trial of patients who received either raTKA (n = 120) or cTKA (n = 101) at 6 different surgical centers. Variables of interest included occurrence of soft tissue release, complications and revisions at minimum one-year follow-up. Satisfaction, pain (numeric rating scale [NRS]), 5-dimensional European Quality of Life (EQ-5D-5 L) questionnaire (index and visual analog scale [VAS]), Oxford Knee Score (OKS), and the Forgotten Joint Score (FJS-12) were collected pre-operatively, and at six weeks, three months, and 12 months post-operative.

Results: There were significantly less soft tissue releases with raTKA (28/120, 23.3%) vs. cTKA (51/99, 51.5%), p < 0.0001). There were significantly fewer cases of medial/lateral instability in the raTKA group at six-weeks (p = 0.038) and three-months (p = 0.007) post-operative. At one-year follow-up, 96.3 and 92.5% of raTKA and cTKA patients were satisfied with the overall results of their surgery, respectively. Significantly more raTKA patients were very satisfied (32.1% vs. 14.6%) with their ability to do home/yard work at six weeks (p = 0.018). Significantly (p = 0.042) less raTKA patients were dissatisfied (5.1% vs. 12.9%) with their ability to perform recreation at one-year post-operative. The EQ-5D-5 L increased significantly (p = 0.042) more in the raTKA group at one-year post-operative (0.529 ± 0.335 vs. 0.417 ± 0.323), but did not exceed the minimal clinical important difference.

Conclusion: raTKA was associated with fewer soft tissue release procedures and medial/lateral instability with greater satisfaction in performing home/yard work at six-weeks post-operative. raTKA was equivalent to cTKA for overall satisfaction, quality of life, and knee-specific patient reported outcome measures in the early post-operative period.

Level of evidence: II.