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Jean-Pierre St Mart Department of Trauma and Orthopaedics, King’s College Hospital, London, UK

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En Lin Goh Oxford University Clinical Academic Graduate School, Medical Sciences Division, University of Oxford, Oxford, UK

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  • Robotic total knee arthroplasty (TKA) has demonstrated improved component positioning and a reduction of alignment outliers with regard to pre-operative planning.

  • Early robotic TKA technologies were mainly active systems associated with significant technical and surgical complications.

  • Current robotic TKA systems are predominantly semi-active with additional haptic feedback which minimizes iatrogenic soft tissue injury compared to conventional arthroplasty and older systems.

  • Semi-active systems demonstrate advantages in terms of early functional recovery and hospital discharge compared to conventional arthroplasty.

  • Limitations with current robotic technology include high upfront costs, learning curves and lack of long-term outcomes.

  • The short-term gains and greater technical reliability associated with current systems may justify the ongoing investment in robotic technology.

  • Further long-term data are required to fully ascertain the cost-effectiveness of newer robotic systems.

Cite this article: EFORT Open Rev 2021;6:270-279. DOI: 10.1302/2058-5241.6.200052

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Jean-Pierre St Mart Department of Trauma and Orthopaedics, King’s College Hospital, London, UK

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En Lin Goh Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK

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Zameer Shah Department of Trauma and Orthopaedics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

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  • Robotic systems used in orthopaedics have evolved from active systems to semi-active systems.

  • Early active systems were associated with significant technical and surgical complications, which limited their clinical use.

  • The new semi-active system Mako has demonstrated promise in overcoming these limitations, with positive early outcomes.

  • There remains a paucity of data regarding long-term outcomes associated with newer systems such as Mako and TSolution One, which will be important in assessing the applicability of these systems.

  • Given the already high satisfaction rate of manual THA, further high-quality comparative studies are required utilizing outcome scores that are not limited by high ceiling effects to assess whether robotic systems justify their additional expense.

Cite this article: EFORT Open Rev 2020;5:866-873. DOI: 10.1302/2058-5241.5.200037

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