The role of next-generation robotic systems in transforming knee arthroplasty: precision and beyond

Robotic-assisted total knee arthroplasty (RATKA) signifies a paradigm shift in orthopedic surgery, offering enhanced precision, implant alignment, and functional outcomes. Despite extensive research, gaps persist in understanding the clinical advantages, adoption challenges, and cost-effectiveness of RATKA. This review critically examines the evolution of RATKA technologies, focusing on their impact on patient outcomes, learning curves, and cost considerations. It also explores innovative robotic systems, including the MISSO robotic platform, developed in India. While designed to accommodate specific anatomical requirements, MISSO demonstrates the adaptability to cater to global patient demands, addressing the needs of diverse populations worldwide. By integrating advanced algorithms, real-time feedback, and autonomous capabilities, RATKA systems achieve sub-millimeter precision, minimize soft tissue trauma, and expedite recovery. Systems like the fully autonomous CUVIS Joint Robot and surgeon-guided ROSA and CORI Knee platform showcase superior accuracy in implant placement and ligament balancing compared to conventional techniques. This review is not limited to the Indian healthcare system but provides a global perspective for orthopedic surgeons and patients. It highlights the transformative potential of RATKA across various healthcare settings, addressing challenges such as high costs, steep learning curves, and regulatory barriers. Through comprehensive analysis and comparisons, the review bridges critical gaps in the literature and proposes strategies for overcoming limitations, fostering broader adoption of robotic technologies. By offering nuanced insights, this work aims to guide the orthopedic community toward achieving optimal patient outcomes and advancing the global standards of knee arthroplasty.