The current state of robotics in total knee arthroplasty

Robotic total knee arthroplasty (TKA) has demonstrated improved component positioning and a reduction of alignment outliers with regard to pre-operative planning.Early robotic TKA technologies were mainly active systems associated with significant technical and surgical complications.Current robotic TKA systems are predominantly semi-active with additional haptic feedback which minimizes iatrogenic soft tissue injury compared to conventional arthroplasty and older systems.Semi-active systems demonstrate advantages in terms of early functional recovery and hospital discharge compared to conventional arthroplasty.Limitations with current robotic technology include high upfront costs, learning curves and lack of long-term outcomes.The short-term gains and greater technical reliability associated with current systems may justify the ongoing investment in robotic technology.Further long-term data are required to fully ascertain the cost-effectiveness of newer robotic systems. Cite this article: EFORT Open Rev 2021;6:270-279. DOI: 10.1302/2058-5241.6.200052.