The Perception and Adoption of Robotic Total Joint Arthroplasty: An Analysis of the United States

The use of robotic assistance in total joint arthroplasty (TJA) continues to rise in the United States (US). The purpose of this study was to investigate the perspectives and rationale for the adoption of robotics by practicing orthopaedic surgeons. We aimed to assess 1) trends in the interest and use of robotic-assisted TJA; 2) robotic use by procedure type and manufacturer; and 3) the most important reasons for the use of robotic assistance in TJA.

A double-blinded online survey was distributed to US orthopaedic surgeons in October 2023. There were 200 surgeons included who were in practice for at least two years, had no consulting agreement with a major manufacturer, and performed at least 100 TJA procedures annually. The survey asked questions regarding interest and current use of robotic-assisted TJA, use patterns between different arthroplasty procedures, and reasons for these utilization decisions. Respondents described their responses over a five-year period, from 2019 to 2023. Survey responses were collected and analyzed with descriptive statistics.

There was a notable rise in surgeons who have already adopted robotics, from 10% in 2018 to 35% in 2023. Surgeons who had less than 10 years in practice had the greatest interest in robotics, which increased yearly. Partial knee arthroplasty had the greatest utilization of robotics among arthroplasty procedures, at 43%, followed by total knee and hip arthroplasty at 36 and 20%, respectively. Surgical efficiency and ease of use were rated to be the most important reasons for implementing robotics in TJA.

Robotic assistance in TJA continues to rise in the US, with the greatest interest seen among younger surgeons. Surgeons found that intraoperative factors, including ease of use and efficiency, were the most important reasons for adoption. Further studies are needed to better evaluate longer-term use patterns and clinical outcomes.