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Why Do Robotic Total Knee Arthroplasties Fail?

Stefano Ghirardelli1, Carmelo Burgio1, Daniel A Driscoll1

  • 1Department of Orthopaedic Surgery, Hospital for Special Surgery, New York New York.

The Journal of Arthroplasty
|April 12, 2026
PubMed
Summary
This summary is machine-generated.

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Robotic total knee arthroplasty (TKA) can lead to complications, with stiffness being the most common. While robotic TKA shows promise, further trials are needed to confirm its long-term benefits and failure rates.

Area of Science:

  • Orthopedic Surgery
  • Medical Robotics
  • Arthroplasty Research

Background:

  • Robotic platforms offer potential for enhanced precision in total knee arthroplasty (TKA).
  • The long-term impact of robotic assistance on TKA failure rates remains under investigation.
  • Understanding aseptic failure modes is crucial for optimizing robotic TKA procedures.

Purpose of the Study:

  • To characterize aseptic failure types after robotic TKA.
  • To analyze subsequent interventions and reoperations following robotic TKA.
  • To evaluate the incidence and patterns of complications in robotic primary TKA.

Main Methods:

  • Retrospective review of 2,648 robotic TKAs performed between January 2016 and May 2024.
  • Exclusion criteria included prior infection, posttraumatic arthritis, or hardware, with a minimum 12-month follow-up.
Keywords:
complicationsprimary total knee arthroplastyreoperationsrevisionsrobotic knee arthroplasty

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  • Analysis of complication types and reoperation rates in a large cohort of robotic TKA patients.

    • Main Results:

    • A total of 7.7% of patients experienced complications, with 6.2% requiring intervention and 1.5% needing revision TKA.
    • Stiffness (5.5%) was the most frequent aseptic complication, followed by chronic pain (0.7%).
    • Infections occurred in 0.8% of cases, while aseptic loosening and instability were infrequent (0.1% and 0.2%, respectively).

    Conclusions:

    • Aseptic failures, particularly stiffness, can occur following robotic TKA.
    • Traditional early failure modes like instability and aseptic loosening appear less common with robotic assistance.
    • Further comparative clinical trials are essential to validate these findings and define the role of robotic TKA systems.