Review of contemporary robotic systems used in total knee arthroplasty

Recent advances in orthopedic technologies have significantly increased surgeons’ interest in robotic systems used for total knee arthroplasty. The use of robotic platforms in routine clinical practice enhances the precision of implant component positioning, improves soft tissue balance, and potentially shortens postoperative recovery time. This work aimed to provide a comparative overview of modern robotic systems utilized in primary total knee arthroplasty. A systematic search of scientific data was conducted in the PubMed, Scopus, ResearchGate, and eLIBRARY databases using relevant keywords in both Russian and English. The review includes randomized and non-randomized studies, meta-analyses, narrative reviews, and systematic reviews published over the past five years. Active and semi-active systems are identified and described in detail, along with their operating mechanisms, features of preoperative planning (image-based vs image-less), and differences between open and closed platforms. Comparative characteristics of the most widely used systems—ROSA, MAKO, VELYS, CORI, and Cuvis Joint—are presented, highlighting their advantages and limitations according to our opinion. The analysis demonstrates that none of the systems is universal; each has its own strengths and weaknesses, and the choice depends on the surgeon’s preferences, the team’s experience, and the capabilities of the medical institution. Despite the high cost of equipment and the need for specialized training, robotic technologies continue to develop rapidly and are being increasingly adopted in orthopedic surgery, including in Russia, underscoring their potential to improve treatment outcomes for patients with gonarthrosis.