Robotic-assisted arthroplasty shows higher patient satisfaction and quality of life for total knee replacement; comparable infection rates to conventional surgery for total hip replacement

NEW ORLEANS, March 2, 2026 /PRNewswire/ -- Robotic-assisted total joint arthroplasty (TJA) continues to gain popularity, with the volume of robotic-assisted procedures increasing 601.2% between 2015 and 2020.ⁱ New research presented at the 2026 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) adds to the growing body of evidence supporting the technology, showing higher patient satisfaction one year after surgery for total knee arthroplasty (TKA) and comparable infection rates between robotic-assisted and conventional total hip arthroplasty (THA).

According to OrthoInfo, computer navigation and robotic tools used in TJA allow orthopaedic surgeons to provide three-dimensional planning before surgery and real-time sensory feedback during surgery. These technologies help surgeons remove damaged bone and cartilage, position implants with greater precision and preserve healthy tissue.

STUDY OVERVIEW AND OUTCOMES

Robotic-Assisted TKA Is Associated with Improved Quality of Life and Increased Patient Satisfaction One Year After Surgery
Knee osteoarthritis is the most prevalent joint disease in the United States and is a leading cause of pain, disability and functional impairment.

"Although total knee replacement is a highly successful procedure, 15 to 20% of patients report dissatisfaction one year after surgery," said David C. Ayers, MD, FAAOS, primary investigator and Distinguished Professor of Orthopaedic Surgery at UMass Chan Medical School in Worcester, Mass. "The goal of a total knee replacement is to improve quality of life by reducing pain and restoring function. As such, we must seize the opportunity for improvement, particularly as nearly one million TKAs are performed annually, and that number is expected to increase over the next 10 to 20 years."

This prospective study evaluated whether robot-assisted TKA (raTKA) was associated with improved quality of life (QOL) and patient satisfaction compared with conventional TKA (cTKA) at one year after surgery.

Patients undergoing unilateral primary raTKA and cTKA at a single institution were enrolled. QOL was assessed using the Knee Injury and Osteoarthritis Outcome Score-12 (KOOS-12) collected before surgery and at one year postoperatively. Patient satisfaction was assessed at one year using the International Society of Arthroplasty Registries (ISAR) satisfaction scale.

Among 1,154 patients included in the study, raTKA was associated with significantly greater improvements in QOL. Multivariable regression showed KOOS-12 QOL scores improved by an average of five points more in the raTKA group compared with cTKA.

• Among patients under 75 years of age, raTKA was associated with significantly higher satisfaction (93.5% satisfied in the raTKA group vs. 84.6% in the cTKA group).
• Multivariate regression analysis further showed that raTKA patients are 3.2 times more likely to be satisfied when compared to cTKA patients [Odds Ratio = 3.2, 95% control incidence (1.22-8.47); p = 0.018)

"There are definite advantages regarding the reproducibility, accuracy, and precision of TKA with the robot and computer navigation, and this research demonstrates a clinically meaningful benefit for patients," said Dr. Ayers. "In the future, larger multicenter studies including well-designed randomized control trials are needed to validate these findings and evaluate their success across diverse patient populations and surgical settings."

Navigating Infection Risks: The Safety and Efficiency of Robotic Techniques in THA
Periprosthetic joint infection (PJI) and superficial site infection (SSSI) remain rare but serious complications following THA. One concern surrounding robotic-assisted THA (raTHA) is whether increased operative time could increase the risk of infection.

"Robotic-assisted surgery introduces theoretical concerns, including increased operative time, additional instrumentation, and the potential for microbial entry through tracking pins or reference arrays," said Josef Jolissaint, MD, primary investigator of the study and orthopaedic surgeon at OrthoCarolina in Charlotte, NC. "We wanted to determine whether those concerns translated into a higher infection risk for patients undergoing THA."

Dr. Jolissaint and his team conducted a large, prospective study for all primary THA procedures performed at a high-volume academic orthopaedic medical center from January 2018 to December 2024. Patient demographics, case duration and use of robotics or navigation were evaluated. Infection outcomes, including SSSI and PJI, were monitored for 90 days postoperatively using a dedicated surveillance program in accordance with National Healthcare Safety Network criteria. Logistic regression was performed to control for known confounders, including age, gender, body mass index (BMI), surgical duration, surgical approach (anterior vs. posterior), diabetes and smoking history.

Among the 31,795 primary THAs analyzed, 15,848 used conventional techniques and 15,947 used robotic or navigated techniques. Key findings included:

• There were no significant differences in SSSI or PJI rates between conventional and individual robotic or navigated techniques, despite a modest 4.4-minute increase in operative time for robotic-assisted procedures (91.5 vs. 87.1 minutes).
• When analyzed as a cohort, robotic and navigated techniques showed no significant difference in PJI (0.18% vs. 0.30%, p = 0.06) or SSSI rates (0.18% vs. 0.26%, p = 0.14) compared with conventional techniques.

"These findings reinforce that robotic-assisted and navigated approaches can be safely integrated into routine clinical practice, including academic and high-volume centers with trainees," said Dr. Jolissaint. "As the demand for reproducible, high-quality outcomes for THA continues to grow, these technologies offer a safe pathway for enhancing surgical precision without compromising infection safety."

2026 AAOS Annual Meeting Disclosure Statement

About AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level to best treat patients in their daily practices. AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality.

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[i] Walgrave S., Oussedik S. Comparative assessment of current robotic-assisted systems in primary total knee arthroplasty. Bone Jt Open. 2022;4:13–18. doi: 10.1302/2633-1462.41.BJO-2022-0070.R1.

SOURCE American Academy of Orthopaedic Surgeons