60 patients with knee osteoarthritis and undergoing primary total knee arthroplasty (TKA) were randomized to one of two groups: robot-assisted or conventional TKA. The study aimed to determine whether there was a significant difference in terms of coronal plane mechanical axis alignment outliers, restoration of joint line, clinical outcome measures, length of stay, operative time, and complications. Radiograhic assessment was carried out at 1 month postoperatively, and clinical outcome measures were assessed at 6 months postoperatively. The results indicated that the robot-assisted group had a lower rate of mechanical axis outliers (>3deg deviation from neutral), as well as more accurate joint line restoration, but no significant difference between groups when considering clinical outcome, operative time, or length of stay.