Outcomes of Bilateral Staged TKA in Patients Who Underwent both Conventional TKA and Robotic TKA: A Single Surgeon’s Experience

Introduction: Total Knee Arthroplasty (TKA) is a leading treatment for severe knee osteoarthritis, offering improved function and pain relief. While conventional TKA is well-established, robotic-assisted TKA provides enhanced precision in implant placement and soft tissue balance, potentially reducing surgery time and cost. However, its effectiveness and complication rates require further study to validate its benefits over conventional methods. This study aims to report the outcomes of CTKA and RTKA performed for the same patient as a bilateral staged TKA. Methods: It is a cross-sectional design conducted at a tertiary center. It includes collecting retrospective data on patients undergoing bilateral staged TKA performed by a single senior arthroplasty surgeon, analyzed using IBM SPSS 29.0.0. Results: Our study analyzed 38 knee surgeries for 19 patients, split equally between robotic (RTKA) and conventional (CTKA) methods. Both groups showed similar demographics and surgical settings. RTKA had a longer mean operative time (105.3 minutes, SD=12.9) compared to CTKA (81.4 minutes, SD=10.8, p<0.001) and a shorter hospital stay (4.2 days vs. 5.6 days, p=0.006). Complications were minimal, with no significant differences in blood loss, post-operative complications, or narcotic use after three weeks between the groups. Both groups showed significant functional gains with KOOS improved from 14.2-16.8 to 84.4-87.0 (p < 0.001), and WOMAC decreased from 83.9-85.3 to 18.5-26.2 (p < 0.001). Subdomain analysis revealed greater pain improvement in conventional TKA and superior daily activity and QoL gains in robotic TKA (p < 0.001). Conclusion: Our study reveals that robotic-assisted TKA results in longer operative periods, but shorter hospital stays compared to conventional TKA. Both methods show similar rates of blood loss, complications, and post-operative narcotic use. Robotic TKA offered better recovery in daily activities and quality of life while conventional TKA achieved greater pain reduction. Overall, both methods proved safe and effective for functional improvement after knee replacement.