Robotic Systems in Knee Surgery: Current Concepts and Future Perspectives

Total knee arthroplasty (TKA) is a successful and highly effective procedure in most patients with tricompartmental knee arthritis. Despite the innovations in surgical techniques due to planning software and technological innovations, patients’ dissatisfaction after TKA is still high, at up to 20%. Robotic-assisted surgery (RAS) could be considered as a future option for improving outcomes due to its higher accuracy, precision, and reliability. Robotic systems can be classified as fully active, semi-active, or passive depending on the surgeon’s involvement during the procedure, and as imageless or image-based according to the necessity of radiological exams for the pre-operative planning. Three of the most well-known robotic systems for knee surgery are MAKO® (Stryker Ltd., Kalamazoo, MI, USA), NAVIO® (Smith & Nephew, Andover, TX, USA), and ROSA® (Zimmer Inc., Warsaw, IN, USA). These systems show differences in terms of surgeon involvement, the use of CT scans or X-rays for pre-operati...