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Robot-assisted total hip arthroplasty: does improved precision translate into better clinical outcomes? A systematic
Ernesto Muñoz-Mahamud1,2,3, Miquel Cortés-Rovira1, Alfonso Alías-Petralanda2
1Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036, Barcelona, Spain.
Purpose:
Robot-assisted total hip arthroplasty (R-THA) is being adopted progressively because of its potential to improve implant positioning and restore hip biomechanics more accurately than conventional techniques. However, whether these technical advantages translate into meaningful clinical benefits remains uncertain. This systematic review compared robot-assisted and conventional THA regarding implant positioning, restoration of hip biomechanics, functional outcomes, and complications.
Materials And Methods:
A systematic review was performed according to the PRISMA guidelines. PubMed and Scopus were searched for comparative studies published between 2015 and September 2025 evaluating robot-assisted versus conventional THA. After applying predefined eligibility criteria, 13 studies were included. Methodological quality was assessed using the MINORS and RoB 2 tools, and findings were synthesized qualitatively.
Results:
Robot-assisted THA was consistently associated with greater accuracy of acetabular component placement within established safe zones and more precise restoration of limb length. Functional outcomes were inconsistent across studies, with no clear evidence of superior patient-reported outcomes or overall clinical benefit. Several studies reported lower rates of dislocation and reoperation following robot-assisted THA, although differences in overall complication rates were less consistent.
Conclusions:
Robot-assisted THA improves the accuracy of implant positioning and better reproduces the preoperative surgical plan than conventional THA. However, these technical advantages have not translated into superior functional outcomes in the short to medium term. Longer-term studies are needed to determine their impact on implant survival.