Sixty patients with end-stage knee osteoarthritis were enrolled in a single-centered, randomized controlled trial and were allocated to undergo either robot-assisted total knee arthroplasty (TKA) with standardized laxity assessment or conventional total knee arthroplasty using a manual tensioner. At two-year follow-up, all 30 patients in the robotic group and 27 of 30 patients (90%) in the conventional group were available for analysis. The primary outcomes of interest were patient-reported outcome measures, including Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and EuroQoL-5D (EQ-5D-5L), as well as the proportion of patients achieving the patient acceptable symptom state (PASS). Secondary outcomes included coronal alignment and coronal laxity assessed using full-leg standing radiographs and stress radiographs. Outcomes were assessed preoperatively and at two years postoperatively. Overall, the results of the study revealed no clinically important or statistically significant differences between groups for patient-reported outcomes, achievement of PASS thresholds, coronal alignment, or coronal laxity. These findings indicate that standardized intraoperative robotic laxity assessment does not confer measurable clinical benefit at two years compared with conventional techniques.