Robotic Assisted Versus Manual Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.
4 affiliations
- 1Imperial College London, London, UK.
- 2University of Birmingham, Birmingham, UK.
- 3Imperial College Healthcare NHS Trust, London, UK.
- 4Plovdiv Medical University, Plovdiv, Bulgaria.
Abstract
Background
Robotic-assisted unicompartmental knee arthroplasty (rUKA) aims to enhance the precision and reproducibility of implant positioning compared with manual UKA (mUKA). This systematic review and meta-analysis compared radiographic, clinical, and patient-reported outcomes between rUKA and mUKA.Methods
A systematic search was conducted in PubMed, MEDLINE, EMBASE, Scopus and Web of Science (July 2025) for comparative studies of rUKA and mUKA, in line with the PRISMA statement. Data were pooled using random-effects models, with effect sizes expressed as mean difference (MD), standardized mean change (SMC), or odds ratio (OR) with 95% confidence intervals (CIs).Results
Thirty-four studies encompassing 68,196 UKAs (22,585 robotic; 45,611 manual) were included. rUKA demonstrated significantly lower complication (OR 0.66, 95% CI 0.44-0.99; p = 0.045) and revision rates (OR 0.54, 95% CI 0.39-0.75; p < 0.001). Operative time was longer for rUKA (+16.1 min; 95% CI 10.8-21.4), while length of stay trended shorter (MD -0.2 days; p = 0.44). rUKA was associated with greater functional outcomes, including higher KSS Knee (MD 2.49; p = 0.007), KSS Function (MD 2.33; p = 0.008), and Oxford Knee Score (SMC 1.06; p = 0.049). Radiographically, rUKA yielded lower tibial slope deviation (MD -1.75°; p < 0.001) and reduced variability in tibial slope and hip-knee-ankle alignment.Conclusion
rUKA may offer benefit compared to mUKA across radiographic precision, complications, revisions, and functional outcomes, though high heterogeneity in study design and the absence of UKA-specific minimal clinically important difference thresholds limits the relevance of any rUKA benefit at present. Further large, multicenter, and methodologically robust studies are needed to confirm long-term results and better define the role of rUKA in clinical practice.
Related
- Substantial improvement in short-term survivorship in patients receiving robotic arm-assisted medial unicompartmental knee arthroplasty : a retrospective cohort study
- Navigation-Assisted and Robotic Total Hip, Knee, and Unicompartmental Arthroplasty: Reconciling Positioning Accuracy with Biomaterial Performance and Long-Term Implant Survival.
- Agreement and Systematic Differences Between Intraoperative ROSA Hip-Knee-Ankle Measurements and Standing Radiographic Alignment After Robotic-Assisted Total Knee Arthroplasty: A Retrospective Agreement Study
- Comparison of Conventional Total Knee Arthroplasty Versus Robotic-Assisted Total Knee Arthroplasty in Primary Osteoarthritis of the Knee: A Prospective Comparative Pilot Study
- Image-based robotic-assisted patellofemoral arthroplasty for isolated patellofemoral osteoarthritis: Short-term survivorship, clinical and radiographic outcomes
BibTeX
@article{kanakala2026robotic,
title = {{Robotic Assisted Versus Manual Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.}},
author = {Sree Kanakala and Kapil Sugand and Jennifer Tasong and Adrisa Prashar and Harjas Singh Shinmar and Srikar Reddy Namireddy and Saran Singh Gill},
journal = {Orthopaedic surgery},
year = {2026},
month = oct,
doi = {10.1111/os.70424},
url = {https://europepmc.org/article/MED/42908376},
note = {CC BY},
}
RIS
TY - JOUR
TI - Robotic Assisted Versus Manual Unicompartmental Knee Arthroplasty: A Systematic Review and Meta-Analysis.
AU - Sree Kanakala
AU - Kapil Sugand
AU - Jennifer Tasong
AU - Adrisa Prashar
AU - Harjas Singh Shinmar
AU - Srikar Reddy Namireddy
AU - Saran Singh Gill
PY - 2026
DA - 2026/10/22
JO - Orthopaedic surgery
DO - 10.1111/os.70424
UR - https://europepmc.org/article/MED/42908376
AB - Background Robotic-assisted unicompartmental knee arthroplasty (rUKA) aims to enhance the precision and reproducibility of implant positioning compared with manual UKA (mUKA). This systematic review and meta-analysis compared radiographic, clinical, and patient-reported outcomes between rUKA and mUKA.Methods A systematic search was conducted in PubMed, MEDLINE, EMBASE, Scopus and Web of Science (July 2025) for comparative studies of rUKA and mUKA, in line with the PRISMA statement. Data were pooled using random-effects models, with effect sizes expressed as mean difference (MD), standardized mean change (SMC), or odds ratio (OR) with 95% confidence intervals (CIs).Results Thirty-four studies encompassing 68,196 UKAs (22,585 robotic; 45,611 manual) were included. rUKA demonstrated significantly lower complication (OR 0.66, 95% CI 0.44-0.99; p = 0.045) and revision rates (OR 0.54, 95% CI 0.39-0.75; p < 0.001). Operative time was longer for rUKA (+16.1 min; 95% CI 10.8-21.4), while length of stay trended shorter (MD -0.2 days; p = 0.44). rUKA was associated with greater functional outcomes, including higher KSS Knee (MD 2.49; p = 0.007), KSS Function (MD 2.33; p = 0.008), and Oxford Knee Score (SMC 1.06; p = 0.049). Radiographically, rUKA yielded lower tibial slope deviation (MD -1.75°; p < 0.001) and reduced variability in tibial slope and hip-knee-ankle alignment.Conclusion rUKA may offer benefit compared to mUKA across radiographic precision, complications, revisions, and functional outcomes, though high heterogeneity in study design and the absence of UKA-specific minimal clinically important difference thresholds limits the relevance of any rUKA benefit at present. Further large, multicenter, and methodologically robust studies are needed to confirm long-term results and better define the role of rUKA in clinical practice.
SN - 1757-7853
SN - 1757-7861
ER -