Overview of approved robotic systems for knee and hip arthroplasty: a narrative review.
8 affiliations
- 1Department of Trauma and Reconstructive Surgery, University Hospital of Halle, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
- 2Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), Bolzano, Italy.
- 3Department of Life Sciences, Health, and Health Professions, Link Campus University, Rome, Italy.
- 4Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University "La Sapienza" of Rome, Rome, Italy.
- 5School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke-on-Trent, UK.
- 6Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Mile End Hospital, London, UK.
- 7Department of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, Simmerath, Germany.
- 8Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospital, New Delhi, India.
Abstract
Robotic assistance in arthroplasty is now embedded in routine practice across many centres, yet information about which platforms are validated, what they can be used for legally, and how they differ technically is dispersed across regulatory notices and heterogeneous clinical reports. This narrative review synthesises PubMed-indexed evidence and primary regulatory sources to provide a comprehensive overview of currently approved systems for knee and hip arthroplasty. PubMed, Web of Science, and Scopus were searched in August 2025 to identify relevant literature on approved robotic systems for knee and hip arthroplasty. Primary regulatory sources were also consulted to confirm approval status, indications, and technical characteristics. Architectures include active robots that autonomously mill bone, semi-active platforms that constrain surgeons' actions within haptic boundaries or guide saw cuts, and handheld solutions that add motorised control with real-time navigation. Imaging strategies span computed tomography-based planning, imageless intraoperative mapping, and fluoroscopy-guided registration in selected hip and knee applications. Most platforms are closed to the manufacturer's implant ecosystem, while a smaller group operates as open platforms with multi-implant compatibility. Across major markets, approvals are concentrated on total knee arthroplasty, with several systems also cleared for unicondylar knee arthroplasty and one imageless handheld platform carrying a specific indication for selected revision knee procedures. In the hip domain, approvals focus on total hip arthroplasty, and dedicated indications for hip hemiarthroplasty were not identified. Adoption has expanded in North America, Europe, and the Asia-Pacific region, supported by evidence of improved radiographic precision and safety broadly comparable to conventional techniques. However, claims of clinical superiority between platforms remain unproven and are confounded by differences in workflows, implants, and learning curves. By consolidating technical characteristics, approved indications, and regulatory status, this review may facilitate the selection, procurement, and implementation of these technologies and inform future work on interoperability, training, and value.
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BibTeX
@article{migliorini2026overview,
title = {{Overview of approved robotic systems for knee and hip arthroplasty: a narrative review.}},
author = {Filippo Migliorini and Nicola Maffulli and Luise Schäfer and Francesco Simeone and Raju Vaishya and Andreas Bell},
journal = {Annals of joint},
year = {2026},
month = oct,
doi = {10.21037/aoj-2026-0030},
url = {https://europepmc.org/article/MED/42999771},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Overview of approved robotic systems for knee and hip arthroplasty: a narrative review.
AU - Filippo Migliorini
AU - Nicola Maffulli
AU - Luise Schäfer
AU - Francesco Simeone
AU - Raju Vaishya
AU - Andreas Bell
PY - 2026
DA - 2026/10/21
JO - Annals of joint
DO - 10.21037/aoj-2026-0030
UR - https://europepmc.org/article/MED/42999771
AB - Robotic assistance in arthroplasty is now embedded in routine practice across many centres, yet information about which platforms are validated, what they can be used for legally, and how they differ technically is dispersed across regulatory notices and heterogeneous clinical reports. This narrative review synthesises PubMed-indexed evidence and primary regulatory sources to provide a comprehensive overview of currently approved systems for knee and hip arthroplasty. PubMed, Web of Science, and Scopus were searched in August 2025 to identify relevant literature on approved robotic systems for knee and hip arthroplasty. Primary regulatory sources were also consulted to confirm approval status, indications, and technical characteristics. Architectures include active robots that autonomously mill bone, semi-active platforms that constrain surgeons' actions within haptic boundaries or guide saw cuts, and handheld solutions that add motorised control with real-time navigation. Imaging strategies span computed tomography-based planning, imageless intraoperative mapping, and fluoroscopy-guided registration in selected hip and knee applications. Most platforms are closed to the manufacturer's implant ecosystem, while a smaller group operates as open platforms with multi-implant compatibility. Across major markets, approvals are concentrated on total knee arthroplasty, with several systems also cleared for unicondylar knee arthroplasty and one imageless handheld platform carrying a specific indication for selected revision knee procedures. In the hip domain, approvals focus on total hip arthroplasty, and dedicated indications for hip hemiarthroplasty were not identified. Adoption has expanded in North America, Europe, and the Asia-Pacific region, supported by evidence of improved radiographic precision and safety broadly comparable to conventional techniques. However, claims of clinical superiority between platforms remain unproven and are confounded by differences in workflows, implants, and learning curves. By consolidating technical characteristics, approved indications, and regulatory status, this review may facilitate the selection, procurement, and implementation of these technologies and inform future work on interoperability, training, and value.
SN - 2415-6809
ER -