Robotic-assisted Total Knee Arthroplasty (TKA) has gained recent prominence with improved technology and wider availability. To date, the literature has demonstrated the ability of robotic-assisted surgeries to produce more accurate alignment, but the implications of this difference in terms of function or implant survival has not been clarified. Most studies to date have been relatively small and short-term in nature. In this study, the authors present a large randomized controlled trials, with sound methodology and long-term follow-up (10 years). Overall, they found no significant differences in terms of any radiographic, functional, or survival outcomes with excellent results in both groups. Operative time and tourniquet time were significantly longer in the robotic-assisted group.