International Orthopaedics

, Volume 43, Issue 6, pp 1283–1295 | Cite as

The effectiveness of robotic hip and knee arthroplasty on patient-reported outcomes: A systematic review and meta-analysis

  • Sascha KarunaratneEmail author
  • Michael Duan
  • Evangelos Pappas
  • Brett Fritsch
  • Richard Boyle
  • Sanjeev Gupta
  • Paul Stalley
  • Mark Horsley
  • Daniel Steffens
Review Article



The purpose of the study is to determine the effectiveness of semi-active and active robotic hip and knee arthroplasty on post-operative patient-reported outcomes of function, pain, quality of life and satisfaction with surgery.


PubMed, Medline, Embase and CENTRAL were searched. Included were comparative studies investigating the effectiveness of semi-active or active robotic hip or knee arthroplasty compared to any other surgical intervention on function, pain, quality of life and satisfaction with surgery. Risk of bias and the strength of the evidence were assessed using the Downs and Black tool and the GRADE system, respectively. Relative risks, mean differences and 95% CI were calculated using random-effects models.


Fourteen studies involving 1342 patients were included. All studies compared robotic to conventional surgery, with active robotic surgery evaluated in total hip or knee arthroplasty and semi-active robotic surgery in total hip or unicompartmental knee arthroplasty. Most studies presented some risk of bias, and the strength of evidence was rated as low to very low quality. Random-effects meta-analyses showed that post-operative functional outcomes were comparable between active robotic and conventional total hip and knee arthroplasty at the short-, medium- and long-term follow-up. No significant difference in pain, quality of life and satisfaction with surgery were reported in individual studies.


This systematic and meta-analyses indicates that functional outcomes for patients undergoing active robotic total hip and knee arthroplasty were comparable to conventional surgery. Whether semi-active or active robotic hip or knee arthroplasty is effective in improving post-operative pain, quality of life and satisfaction with surgery is unclear.

PROSPERO Registration Number: CRD42017059932.


Robotic surgery Hip Knee Arthroplasty Patient-reported outcomes 


Compliance with ethical standards

Conflict of interest

Sascha Karunaratne, Michael Duan, Evangelos Pappas, Paul Stalley, Mark Horsley and Daniel Steffens declare that they have no conflict of interest.

Brett Fritsch owns stocks in Optimised Ortho and 360 Knee Systems; has performed consulting work for Optimised Ortho, 360 Knee Systems, Arthrex, Global Orthopaedics and Omni; and has received institutional support from Arthrex, Global Orthopaedics, Zimmer and Smith & Nephew.

Richard Boyle has performed consultancy work for Stryker, Adler, Signature and Global Orthopaedics and receives research assistance from Corin.

Sanjeev Gupta has performed consultancy work for Stryker, Depuy, Global Orthopaedics and Corin.

Supplementary material

264_2018_4140_MOESM1_ESM.pdf (194 kb)
Online Resource 1 (PDF 193 kb)
264_2018_4140_MOESM2_ESM.pdf (30 kb)
Online Resource 2 (PDF 29 kb)
264_2018_4140_MOESM3_ESM.pdf (163 kb)
Online Resource 3 (PDF 162 kb)
264_2018_4140_MOESM4_ESM.pdf (130 kb)
Online Resource 4 (PDF 129 kb)
264_2018_4140_MOESM5_ESM.pdf (58 kb)
Online Resource 5 (PDF 58 kb)


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Surgical Outcomes Research Centre (SOuRCe)Royal Prince Alfred Hospital (RPAH)SydneyAustralia
  2. 2.Faculty of Medicine and HealthThe University of SydneySydneyAustralia
  3. 3.Faculty of Health SciencesThe University of SydneySydneyAustralia
  4. 4.Department of Orthopaedic SurgeryRoyal Prince Alfred Hospital (RPAH)SydneyAustralia

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