Does a robotic knee replacement make a difference?

Read time: 2 minutes

Knee replacements are among the commonest operations done in Australia with tens of thousands each year. Many orthopaedic surgeons now use robotics to help them. This is different from what you may have seen with other robots in surgery such as prostatectomy where the surgeon manipulates robotic arms and tools inside the person’s abdomen or pelvis.

Robotics in knee surgery is about highly sophisticated imaging which is used to program the way the bones are cut and the new joint is placed between the femur and tibia, the two bones above and below the knee joint.

In general the hospital counts for a lot, as does the volume of work the surgeon performs.

Surgeons like it because they feel they get more accurate joint placement, and that makes recovery better and reduces the likelihood of revision surgery.

However, despite this hope, a British study of nearly 700,000 knee replacements between 2018 and 2024 has found that robotics has not changed the revision rate over five years following the surgery when compared to the surgeon doing the operation without robotic assistance. There were also no differences in surgical complications. Recovery rates didn't seem to differ either.

One of the authors accepts that robotics might be indicated in some circumstances, for example where the surgery is going to be complicated.

The bottom line for patients is that they wouldn't choose their surgeon based on whether or not the surgeon uses robotics. They really need to know the surgeon's revision and infection rates, their general approach, how many knee replacements they do and the reputation of the hospital where they work. In general the hospital counts for a lot, as does the volume of work the surgeon performs.

Declaration: By the time you read this I'll have had a robot assisted knee replacement!