Real-World Clinical Outcomes of Robotic-Assisted Total Knee Arthroplasty: A propensity-Matched Comparative Study

Authors

• Hassan Yassine, Wayne State University School of MedicineFollow
• Amir Ghafarian, International University of the Health SciencesFollow
• Jawad Saad, Wayne State University School of MedicineFollow
• Abdel Kareem Hilo, Wayne State University School of MedicineFollow
• Muaaz Wajahath, Michigan State University College of Human MedicineFollow
• Khaled Saleh, FAJR GlobalFollow

Research Mentor Name

Khaled Saleh

Research Mentor Email Address

kjsaleh@gmail.com

Institution / Department

Wayne State University School of Medicine; data analyzed using the TriNetx US Collaborative Network

Document Type

Research Abstract

Research Type

clinicalresearch

Graduate Level Research

no

Abstract

Background:

Robotic-assisted total knee arthroplasty (RA-TKA) is increasingly utilized to improve component alignment and soft-tissue balance, yet its impact on clinically meaningful outcomes in large real-world populations remains uncertain. Although prior studies demonstrate improved radiographic accuracy, whether robotic assistance reduces postoperative complications, opioid utilization, or midterm mechanical failure has not been established at scale.

Methods:

We conducted a retrospective, propensity-matched cohort study using the TriNetX US Collaborative Network to identify adults undergoing primary TKA from 2018–2023. Robotic-assisted procedures were defined by CPT 27447 with concurrent robotic navigation codes. Propensity score matching (1:1) was performed to balance demographics and comorbidities, yielding 6,176 patients per cohort. Primary outcomes were 90-day postoperative complications, including all-cause readmission and prescription opioid utilization. Secondary outcomes were two-year mechanical complications: revision surgery, manipulation under anesthesia (MUA), and mechanical loosening.

Results:

RA-TKA was associated with significantly lower 90-day readmission rates compared with non-robotic TKA. Postoperative opioid utilization was also reduced in the robotic cohort. Other early medical and surgical complications were comparable between groups. At two years, RA-TKA demonstrated lower rates of revision surgery and mechanical loosening. MUA rates were similar (3.26% vs. 3.22%; RR 1.01; p=0.919).

Conclusion:

In a large real-world matched cohort, RA-TKA was associated with lower 90-day readmissions, reduced opioid utilization, and fewer mechanical complications at two years. These findings suggest that robotic assistance may improve both short-term recovery and midterm implant performance without increasing early postoperative risk.

Disciplines

Medical Anatomy | Medical Education | Medicine and Health Sciences | Orthopedics | Social and Behavioral Sciences | Surgery

Recommended Citation

Yassine, Hassan; Ghafarian, Amir; Saad, Jawad; Hilo, Abdel Kareem; Wajahath, Muaaz; and Saleh, Khaled, "Real-World Clinical Outcomes of Robotic-Assisted Total Knee Arthroplasty: A propensity-Matched Comparative Study" (2026). Medical Student Research Symposium. 503.
https://digitalcommons.wayne.edu/som_srs/503