Blog · 2026-09-29

Robotic Knee Replacement: How It Works and Is It Better?

PUBLISHED 2026-09-29 · Op. Dr. Serdar Karaman, Orthopedics & Traumatology · Live Taller Now

In short: in robotic knee replacement, the surgeon still performs the operation, but a robotic arm guides the bone cuts to match a detailed pre-operative plan. Studies show more accurate implant positioning and, in some trials, less early pain. Whether that translates into longer-lasting knees or better long-term function has not yet been clearly proven.

What "robotic" really means

The name suggests a machine operating on its own, but that is not what happens. In robotic-arm assisted knee replacement, the surgeon makes the incision, controls the robotic arm and makes every decision. The robot's job is to keep the saw or burr within boundaries set by a plan, so the bone cuts land where the plan says they should. Several systems exist; Mako is one of the best known, and others include ROSA, VELYS and CORI.

How it works, step by step

With some systems, including Mako, a CT scan of the leg is taken before surgery to build a 3D model of your knee. Other systems map the bone surfaces during the operation instead. The surgeon uses the model to plan implant size, position and alignment. During surgery, the system tracks the leg in real time, lets the surgeon assess the soft-tissue balance through the range of movement, and then guides the cuts, stopping the instrument if it moves outside the planned zone.

• Planning from a CT scan or intra-operative mapping.
• Balancing: checking ligament tension before any bone is cut.
• Guided cutting within haptic boundaries.
• Verification of the final position before the implants are fixed.

What the evidence shows

The clearest benefit is accuracy. Robotic systems consistently reduce the number of implants placed outside the intended alignment compared with conventional instruments. Some trials have also reported less pain and quicker early recovery in the first weeks. What remains unproven is the outcome patients care about most over the long term: whether robotic knees last longer or function better years later. Registry and trial data are still maturing, and well-performed conventional knee replacement already has excellent long-term results.

The trade-offs

Robotic surgery can add cost, a CT scan with its radiation dose for some systems, and longer operating time while a team is learning. Most importantly, the robot does not replace judgement: implant choice, soft-tissue handling and rehabilitation still drive the result. Robotic guidance is particularly popular for partial knee replacement, where small positioning errors matter more, as explained in partial knee replacement.

Questions to ask your surgeon

Rather than choosing a hospital for its robot, ask how many knee replacements the surgeon performs each year, how long they have used the system, what their own complication and revision rates are, and what the rehabilitation plan looks like. A highly experienced surgeon using conventional instruments may achieve better results than an inexperienced one with a robot. Recovery follows the same broad timeline either way, set out in knee replacement recovery time, and candidacy for any approach is reviewed on our knee replacement in Turkey page.

Frequently asked questions