It is currently still unknown whether the medium- and long-term results of RA-TKA are superior to those of conventional TKA (C-TKA). Therefore, the purpose of this Editorial has been to identify articles published in PubMed between January 1, 2025, and August 28, 2025, using the keywords “Robotic-assisted TKA 2025.” A total of 168 articles were found, of which only five were ultimately analyzed because they were considered to be of the greatest interest in relation to the title of this Editorial. In conclusion, my opinion is that the most recent literature has not yet demonstrated in a scientifically sound manner that the long-term results of RA-TKA are better than those of C-TKA. Therefore, considering that C-TKA currently offers excellent long-term results for patients with advanced pain osteoarthritis, I believe that RA-TKA cannot be routinely recommended.
Level of evidence: III |
- Clement ND, Weir DJ, Deehan DJ. Robotic-arm assisted total knee arthroplasty: the relationship between bone resection, gap balancing and resultant implant alignment. Arch Bone Jt Surg. 2023; 11(4): 278-284. doi: 10.22038/ABJS.2023.63774.3072.
- Khojastehnezhad MA, Youseflee P, Moradi A, Ebrahimzadeh MH, Jirofti N. Artificial intelligence and the state of the art of orthopedic surgery. Arch Bone Jt Surg 2025;1(1):17-22. doi: 10.22038/ABJS.2024.84231.3829.
- Dretakis K, Raptis K, Koutserimpas C. The use of the robotic arm-assisted system (MAKO) for hip revision surgery. Arch Bone Jt Surg. 2024;12(8): 608-611. doi: 10.22038/ABJS.2024.77543.3582.
- Poursalehian M, Ebrahimzadeh MH, Javadzade E, Mortazavi Sm J. Recent trends and hotspots in knee arthroplasty: a bibliometric analysis and visualization study of the last five-year publications. Arch Bone Jt Surg. 2023;11(9):545-555. doi: 10.22038/ABJS.2023.70791.331.
- Khan ST, Emara AK, Zhou G, Koroukian SM. Robotic-assisted total knee arthroplasty in the USA: nationwide adoption trends towards 70 % by 2030. J Clin Orthop Trauma. 2025;68:103069. doi: 10.1016/j.jcot.2025.103069.
- Mostafa O, Malik M, Qayum K, et al. Robotic-assisted versus conventional total knee arthroplasty: a systematic review and meta-analysis of alignment accuracy and clinical outcomes. Ann Med Surg (Lond). 2025;87(2):867-879. doi: 10.1097/MS9.0000000000002919.
- Chen J, Loke RWK, Lim KK, Tan BWL. Survivorship in robotic total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis. Arthroplasty. 2025; 7(1):21. doi: 10.1186/s42836-025-00304-3.
- Ziedas AC, Michaelson J, Knesek D, Laker M, Frush T, Markel DC. Cemented and cementless robotic-assisted versus manual total knee arthroplasty outcomes: a single center Michigan arthroplasty registry collaborative quality initiative-based study. J Arthroplasty. 2025; 40(10):2637-2643. doi: 10.1016/j.arth.2025.04.043.
- Yang HY, Song EK, Park CJ, Bae KH, Seon JK. Robotic-assisted total knee arthroplasty improves aseptic survivorship compared to conventional total knee arthroplasty: a minimum 15-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2025. doi: 10.1002/ksa.12731.
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