Research presented at the American Academy of Orthopaedic Surgeons annual meeting examines patient outcomes associated with robotic-assisted total joint arthroplasty, reporting higher patient satisfaction following robotic-assisted total knee replacement and infection rates comparable to conventional techniques in total hip replacement.
The use of robotic-assisted systems in total joint arthroplasty has expanded rapidly in recent years. Data cited in the research indicate that the number of robotic-assisted procedures increased by more than 600 percent between 2015 and 2020. According to the organization’s patient education platform OrthoInfo, robotic and computer navigation tools enable three-dimensional preoperative planning and provide surgeons with real-time feedback during procedures, with the aim of improving implant positioning and preserving healthy tissue.
One study evaluated whether robotic-assisted total knee arthroplasty improves quality of life and patient satisfaction compared with conventional total knee arthroplasty. Knee osteoarthritis remains the most common joint disease in the United States and a major contributor to pain and disability.
The study enrolled patients undergoing unilateral primary knee replacement at a single institution. Quality of life was measured using the Knee Injury and Osteoarthritis Outcome Score-12 before surgery and one year after the procedure. Patient satisfaction was assessed at the one-year mark using the International Society of Arthroplasty Registries satisfaction scale.
The analysis included 1,154 patients. Researchers reported that patients who underwent robotic-assisted knee replacement experienced greater improvements in quality-of-life scores than those treated with conventional surgery. Multivariable regression analysis found that the robotic-assisted group showed an average five-point greater improvement in the KOOS-12 quality-of-life measure.
Among patients younger than 75 years, satisfaction rates were higher in the robotic-assisted group, with 93.5 percent reporting satisfaction compared with 84.6 percent in the conventional surgery group. Regression analysis indicated that patients receiving robotic-assisted knee replacement were 3.2 times more likely to report satisfaction one year after surgery.
“Although total knee replacement is a highly successful procedure, 15 to 20% of patients report dissatisfaction one year after surgery,” said David C. Ayers, primary investigator and professor of orthopaedic surgery at UMass Chan Medical School. “The goal of a total knee replacement is to improve quality of life by reducing pain and restoring function. As such, we must seize the opportunity for improvement, particularly as nearly one million TKAs are performed annually, and that number is expected to increase over the next 10 to 20 years.”
A separate study examined infection risks associated with robotic-assisted total hip arthroplasty. Researchers assessed whether factors such as longer operating times or additional instrumentation could increase infection risk compared with conventional procedures.
The study analyzed 31,795 primary hip replacement procedures performed at a high-volume academic orthopaedic medical center between January 2018 and December 2024. Of those procedures, 15,848 used conventional techniques and 15,947 involved robotic or navigated approaches. Researchers evaluated patient demographics, surgical duration and infection outcomes including periprosthetic joint infection and superficial surgical site infection during a 90-day postoperative monitoring period.
The findings indicated no statistically significant difference in infection rates between robotic-assisted or navigated procedures and conventional techniques. Robotic-assisted procedures were associated with an average operating time approximately 4.4 minutes longer than conventional surgery, but this difference did not correspond with higher infection rates. Periprosthetic joint infection occurred in 0.18 percent of cases in the robotic or navigated group compared with 0.30 percent in the conventional group, while superficial surgical site infection rates were 0.18 percent and 0.26 percent, respectively.
“Robotic-assisted surgery introduces theoretical concerns, including increased operative time, additional instrumentation, and the potential for microbial entry through tracking pins or reference arrays,” said Josef Jolissaint, an orthopaedic surgeon at OrthoCarolina and the study’s primary investigator. “We wanted to determine whether those concerns translated into a higher infection risk for patients undergoing THA.”
He added that the results suggest robotic-assisted and navigated approaches can be incorporated into routine clinical practice without increasing infection risk while potentially supporting more consistent surgical outcomes.
