Review of modern robotic systems used in knee arthroplasty

Recent technological advances in orthopedics have significantly increased surgeons’ interest in robotic systems used in total knee arthroplasty (TKA). The use of robotic systems in routine practice allows for more accurate positioning of prosthetic components, improved soft tissue balancing, and potentially shorter postoperative recovery. The aim of this study was to provide a comparative review of modern robotic systems used in primary TKA. A systematic search of publications was conducted in the PubMed, Scopus, ResearchGate, and eLIBRARY databases in Russian and English using relevant keywords. Randomized and non-randomized controlled trials, meta-analyses, narrative and systematic reviews published within the last 5 years were included. Active and semi-active systems, their mechanisms of action, features of preoperative planning (image-based and image-less), and differences between “open” and “closed” platforms are highlighted and discussed. The review presents comparative characteristics of the most common systems — ROSA, MAKO, VELYS, CORI, and Cuvis Joint — including their advantages and disadvantages as evaluated by the authors. The analysis shows that no single system is universal: each has its strengths and weaknesses, and the choice depends on the surgeon’s preferences, team experience, and the clinic’s resources. Despite the high cost of equipment and the need for specialized training, robotic technologies continue to develop and are being increasingly integrated into orthopedic surgical practice, including in Russia. This underlines their promising potential to improve outcomes for patients with knee osteoarthritis.