A large analysis of U.K. registry data found that robotically assisted hip and knee replacements did not improve 5-year implant survival compared with conventional surgery. The studies, reported by MedPage Today and published in The BMJ, covered more than 2.5 million procedures performed from 2018 to 2024 across most of the U.K.
Revision rates were nearly identical for total hip, total knee, and unicompartmental knee replacements. For example, 5-year survival was 98.8% for both robotic and conventional total hips, and 98.6% versus 98.5% for robotic and conventional total knees. The only notable difference was lower survival for robotic unicompartmental knees (96.4% vs 97.8%), but the authors reported no significant differences overall.
The rationale for robotic surgery is better implant positioning, which should reduce early revisions. But these data suggest that benefit, if any, is not large enough to affect revision rates. The researchers estimated that each robotic device costs roughly £1 million to buy, plus £1,000 to £2,500 per procedure. The U.K. government had planned to increase robotic arthroplasty sevenfold under a 10-year NHS plan; these findings could influence NICE guidance on whether to proceed.
The researchers acknowledge limitations: the observational design cannot rule out residual confounding, and most procedures were performed in the NHS, which may limit generalizability to other health systems. There were hints of fewer dislocations and fractures with robotic hips in unmatched analyses, but these differences shrank to insignificance in propensity-matched cohorts. Overall, the source concludes that robotic surgery may be a waste of money for these outcomes.