Robotic Knee Replacement: Is It Really Better

By: Gonzalo Valdivia, MD.

Knee replacement surgery is a life-changing procedure for people suffering from severe arthritis or joint damage. In the last ten years or so, robotic-assisted total knee arthroplasty (R-TKA) has been marketed as a groundbreaking advancement over conventional total knee arthroplasty (C-TKA). The idea of robots assisting in surgery may sound futuristic and superior, but does this technology actually lead to better results for patients?

The truth is that scientific studies do not support the claim that robotic knee replacement is significantly better than traditional knee surgery. While robotic technology can help with precision, current research shows that patients do not experience better pain relief, mobility, or long-term results compared to conventional knee replacements. Let’s break it down.

1.Does Robotic Surgery Improve Outcomes?

Many believe that robotic assistance leads to better knee function, faster recovery, and longer-lasting implants, but research tells a different story.

A 2023 study by Bensa et al. reviewed multiple clinical trials comparing robotic and traditional knee replacements. The findings? No significant difference in patient outcomes—meaning people who received robotic surgery did not experience less pain, improved mobility, or better knee function compared to those who had a standard knee replacement. However, robotic-assisted surgeries did take more time to perform, which could increase risks such as infections or complications. (Bensa et al., 2023).

Another study, published in 2024 by Kirchner et al., analyzed data from the American Joint Replacement Registry and found that robotic-assisted knee replacements did not lead to fewer early implant failures. In other words, robotic surgery does not improve the durability of knee implants. (Kirchner et al., 2024).

2.Does Robotic Surgery Improve Accuracy?

Yes, robotic-assisted surgery does improve the precision of implant placement. However, does this extra precision translate into better movement, less pain, or faster recovery? Not really.

A 2023 review by Ruangsomboon et al. found that while robotic surgery led to better alignment of the knee joint (as seen in X-rays), this did not translate into improved patient satisfaction, pain relief, or long-term success. (Ruangsomboon et al., 2023)

This is an important point because patients want better quality of life, not just perfect X-ray images. If robotic technology does not improve how a person feels after surgery, then its benefits may not justify the additional cost and complexity.

3.Media Hype vs. Medical Reality

Robotic knee surgery has been heavily promoted by hospitals and medical device companies. Many patients assume that "newer" means "better." However, a 2024 study by Ekhtiari et al. found that the media often exaggerates the benefits of robotic knee replacement compared to what scientific research actually shows. (Ekhtiari et al., 2024)

Marketing often highlights words like “cutting-edge” and “revolutionary”, but patients need to focus on evidence, not advertisements. Just because a procedure is performed with robotic assistance does not mean it will lead to better outcomes.

4.Is Robotic Knee Replacement Worth It?

For now, the scientific evidence does not show that robotic knee surgery is better for patients in terms of pain relief, function, or long-term implant success. It does, however, take longer to perform and may cost more.

That doesn’t mean robotic surgery is bad—it just means it is not the game-changer that many people think it is. Patients considering knee replacement should discuss all options with their doctor and focus on choosing a skilled surgeon rather than relying on robotic technology alone.

Bottom Line: What Should Patients Know?

Robotic knee replacement is NOT significantly better than traditional knee replacement in terms of patient outcomes.
Surgery takes longer, which may slightly increase risks.
Improved precision does NOT mean better pain relief or movement.
Marketing often overstates the benefits of robotic technology.
A skilled surgeon is more important than whether the procedure is robotic or traditional.

If you or a loved one are considering knee replacement, make sure to ask your doctor about the evidence behind different surgical methods. A well-performed conventional knee replacement can provide excellent results without the need for robotic assistance.

References

Bensa A, Sangiorgio A, Deabate L, et al. Robotic-Assisted Mechanically Aligned Total Knee Arthroplasty Does Not Lead to Better Clinical and Radiological Outcomes When Compared to Conventional TKA: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Knee Surgery, Sports Traumatology, Arthroscopy. 2023;31(11):4680-4691. doi:10.1007/s00167-023-07458-0.
Kirchner GJ, Stambough JB, Jimenez E, Nikkel LE. Robotic-Assisted TKA Is Not Associated With Decreased Odds of Early Revision: An Analysis of the American Joint Replacement Registry. Clinical Orthopaedics and Related Research. 2024;482(2):303-310. doi:10.1097/CORR.0000000000002783.
Ruangsomboon P, Ruangsomboon O, Pornrattanamaneewong C, Narkbunnam R, Chareancholvanich K. Clinical and Radiological Outcomes of Robotic-Assisted Versus Conventional Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Acta Orthopaedica. 2023;94:60-79. doi:10.2340/17453674.2023.9411.
Ekhtiari S, Sun B, Sidhu R, et al. Evidence Versus Frenzy in Robotic Total Knee Arthroplasty: A Systematic Review Comparing News Media Claims to Randomized Controlled Trial Evidence. The Journal of Bone and Joint Surgery. American Volume. 2024;106(24):2384-2392. doi:10.2106/JBJS.24.00264.