Background:Total Knee Arthroplasty (TKA) has evolved with the advent of robotic assistance, promising enhanced alignment precision and potentially improved patient outcomes. However, comparative evidence from multicenter randomized trials remains limited. This study aims to evaluate postoperative outcomes between robotic-assisted and conventional TKA approaches in a diverse patient population. Materials and Methods:A randomized, multicenter clinical trial was conducted across four tertiary care hospitals, enrolling 240 patients undergoing unilateral TKA. Participants were randomly allocated into two groups: Group A (Robotic-Assisted TKA, n=120) and Group B (Conventional TKA, n=120). Primary outcomes assessed included operative time, hospital stay duration, postoperative pain scores (VAS), range of motion (ROM), and functional outcomes (measured using the Knee Society Score - KSS) at 6 weeks and 6 months postoperatively. Complications were also recorded. Results:The mean operative time was longer in Group A (112.4 ± 15.2 minutes) than Group B (96.7 ± 12.6 minutes). However, Group A demonstrated a significantly shorter hospital stay (3.1 ± 0.9 days vs. 4.3 ± 1.1 days, p<0.01). VAS scores at 48 hours post-surgery were lower in the robotic group (3.6 ± 1.2 vs. 5.1 ± 1.5, p<0.001). At 6 months, Group A had improved ROM (123.4° ± 7.8° vs. 117.1° ± 8.3°, p=0.004) and higher mean KSS (89.2 ± 6.5 vs. 82.6 ± 7.1, p<0.001). The incidence of complications was slightly lower in the robotic group (5% vs. 9%, p=0.27), though not statistically significant. Conclusion:Robotic-assisted TKA offers improved short-term functional outcomes, reduced postoperative pain, and shorter hospitalization compared to conventional techniques, despite longer surgical times. These findings support the integration of robotic systems in orthopedic surgical practice, particularly in high-volume centers.