One hundred and thirty patients with knee osteoarthritis undergoing primary TKA were randomized to receive robotic-arm-assisted TKA (n=65) or conventional TKA (n=65). The primary outcome was the proportion of patients with a mechanical axis deviation of ≤3° between the femur and tibia, assessed via full-length weight-bearing X-rays at six weeks postoperatively. Secondary outcomes included operation time, postoperative functional outcomes measured by the American Knee Society Score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), quality of life (SF-36), and adverse events (AEs). Overall, the results showed that robotic-arm-assisted TKA resulted in significantly better radiographic alignment but had a longer operation time. There were no significant differences in postoperative functional outcomes, quality of life, or adverse events between the groups. The findings suggest that robotic-arm-assisted TKA improves early radiographic alignment but does not confer additional clinical benefits within the early postoperative period.