Robotic-assisted hip and knee replacement

How it works

A CT scan before surgery creates a 3D model of your hip or knee, which I use to plan the size and position of the implants. During the operation I guide a robotic arm that helps prepare the bone and position the implants within the limits of that plan. The robot does not operate on its own.

What the evidence shows

Studies show that robotic assistance positions hip and knee implants more precisely and closer to the plan, and some earlier, smaller studies reported less pain and a quicker recovery in the first weeks after robotic knee replacement. Recent large studies have tested whether this leads to better results for patients:

• RACER-Knee, a UK trial of 339 patients in 10 hospitals, compared Mako robotic-assisted with conventional total knee replacement. The robotic operations were more precise, but at one year there was no significant difference in patients' outcomes, and early recovery and pain were similar (Lancet, 2026).
• RASKAL, an Australian trial of 334 patients, compared robotic-assisted with computer-navigated total knee replacement and found no significant difference in outcomes at one or two years (Bone & Joint Journal, 2026).
• A National Joint Registry study of almost 700,000 knee replacements, including more than 22,000 robotic operations, found no significant difference in the risk of revision (further surgery) in the first few years between robotic and conventional total or partial knee replacements (BMJ, 2026).

So when robotic assistance is used routinely, these studies found no significant difference in outcomes at one year, and standard hip and knee replacements remain excellent operations. There may, however, be a case for robotic assistance in more complex surgery, where placing the components accurately is technically challenging.

Is it right for you?

We will decide together at your consultation. It depends on your joint, the type of implant that suits you, and your insurance, as cover for robotic surgery varies between insurers. Read more about hip replacement, knee replacement and partial knee replacement.

Mako is a trademark of Stryker Corporation.

Costs and insurance

I am recognised by Bupa, AXA Health, Aviva, Vitality, Aetna and Healix. Please check your policy and ask your insurer for a pre-authorisation number before your first appointment. If you are paying for yourself, Nuffield Health Ipswich will give you a fixed-price package after your consultation. See fees and insurance.

Written and reviewed by Mr Krishna Boddu FRCS (Tr & Orth), consultant orthopaedic surgeon, GMC 5206961. Last reviewed: 1 November 2026.

Sources

• Domb BG et al. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clin Orthop Relat Res 2014;472:329–36.
• Kayani B et al. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced short-term inpatient length of stay compared with conventional jig-based total knee arthroplasty. Bone Joint J 2018;100-B:930–7.
• Parsons H et al. Robotic-arm-assisted versus conventional total knee replacement (RACER-Knee): a pragmatic, multicentre, participant-masked and assessor-masked, superiority, randomised controlled trial. Lancet 2026.
• MacDessi SJ et al. Robotic-assisted surgery and functional alignment in total knee arthroplasty: the RASKAL registry-nested 2 × 2 factorial randomized trial. Bone Joint J 2026;108-B:622–33.
• Mohammad HR et al. Early national comparison of robotic versus conventional knee replacements for arthritis using National Joint Registry data: target trial emulation study. BMJ 2026;394:e100691.
• NICE guideline NG157: Joint replacement (primary): hip, knee and shoulder (2020)