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Abstract
Robotic-assisted orthopedic surgery has been available clinically in some form for
over 2 decades, claiming to improve total joint arthroplasty by enhancing the surgeon's
ability to reproduce alignment and therefore better restore normal kinematics. Various
current systems include a robotic arm, robotic-guided cutting jigs, and robotic milling
systems with a diversity of different navigation strategies using active, semiactive,
or passive control systems. Semiactive systems have become dominant, providing a haptic
window through which the surgeon is able to consistently prepare an arthroplasty based
on preoperative planning. A review of previous designs and clinical studies demonstrate
that these robotic systems decrease variability and increase precision, primarily
focusing on component positioning and alignment. Some early clinical results indicate
decreased revision rates and improved patient satisfaction with robotic-assisted arthroplasty.
The future design objectives include precise planning and even further improved consistent
intraoperative execution. Despite this cautious optimism, many still wonder whether
robotics will ultimately increase cost and operative time without objectively improving
outcomes. Over the long term, every industry that has seen robotic technology be introduced,
ultimately has shown an increase in production capacity, improved accuracy and precision,
and lower cost. A new generation of robotic systems is now being introduced into the
arthroplasty arena, and early results with unicompartmental knee arthroplasty and
total hip arthroplasty have demonstrated improved accuracy of placement, improved
satisfaction, and reduced complications. Further studies are needed to confirm the
cost effectiveness of these technologies.