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To gain widespread acceptance, robotic-assisted surgery must add value to total joint arthroplasty by demonstrating improved outcomes and reduced overall costs associated with the episode of care. We review the surgical technique as well as clinical and economic results associated with the introduction of a commercially available robotic-assisted total knee arthroplasty system (OMNIBotics®) in both an academic teaching and a community hospital setting. Clinical results demonstrate highly accurate and reproducible component placement and overall leg alignment, high patient satisfaction and knee functional outcomes as measured by the new Knee Society and KOOS scores, as well as a shortened length of stay and reduced 90-day readmission rates and overall episode of care costs when compared with manual intramedullary-based instrumentation.