Robotic Arthroplasty in Context: Balancing Evidence and Innovation in Joint Replacement.

Fraval, Andrew; Rajgopal, Ashok; Bozic, Kevin J; Bhandari, Mohit; Parvizi, Javad · J Bone Joint Surg Am · 2026

review · Level V

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Abstract

➢ This review examines the contemporary evidence surrounding robotic-assisted joint replacement, including its effects on surgical precision, clinical outcomes, and implant survivorship, and the broader implications for innovation in arthroplasty.➢ Current evidence consistently demonstrates that robotic-assisted arthroplasty improves the precision and reproducibility of component positioning. However, systematic reviews, meta-analyses, randomized trials, and national registry data have not demonstrated consistent improvements in patient-reported outcomes, complication rates, or implant survivorship.➢ The existing literature is limited by statistical fragility, heterogeneity among robotic platforms, and a disconnect between scientific evidence and public enthusiasm.➢ Future value may lie in the integration of robotics with large-scale data acquisition and data-driven personalization, although these concepts remain largely unproven.➢ The experience of robotic-assisted arthroplasty highlights the need for a more rigorous evidence-based framework for innovation in orthopaedic surgery, with adoption guided by demonstrable improvements in patient outcomes and health-care value rather than technical precision alone.