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A Comparison of Operative Time Between Robotic Surgical Assistant (ROSA) and MAKO Robotic-Assisted Total Knee
Brandon Weissman1, Tiger Y Ma2, Kevin Shen3
1Otolaryngology, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Cureus
|October 24, 2025
Summary
Robotic-assisted total knee arthroplasty (TKA) using the ROSA system may offer shorter operative times compared to the MAKO system. However, this difference was not statistically significant in this meta-analysis of TKA procedures.
Area of Science:
- Orthopedic Surgery
- Robotic Surgery
- Medical Technology
Background:
- Robotic-assisted total knee arthroplasty (TKA) aims to improve implant precision and alignment.
- ROSA and MAKO are leading robotic surgical platforms for TKA.
Purpose of the Study:
- To compare operative times between ROSA and MAKO robotic systems in TKA.
- To conduct a meta-analysis of comparative studies on ROSA vs. MAKO for TKA.
Main Methods:
- Systematic literature search of PubMed and Embase up to December 2024.
- Meta-analysis of three comparative studies involving 1,222 patients.
- Calculation of mean differences (MDs) with 95% confidence intervals (CIs) and assessment of heterogeneity.
Main Results:
- A trend favored ROSA, suggesting approximately 6-7 minutes shorter operative time (Hedges' g = 0.21), but this was not statistically significant.
- High heterogeneity (I² = 90%) impacted the random-effects model results.
- No evidence of publication bias was detected via funnel plot analysis.
Conclusions:
- ROSA may offer a slight advantage in reducing operative time during TKA compared to MAKO.
- Substantial heterogeneity and limited study numbers restrict definitive conclusions.
- Further research with larger sample sizes is needed to confirm these findings.
