Robotic-assisted total knee arthroplasty: Systematic review of surgical assist robotic systems available in Japan

Purpose Surgical assistant robots are now available for total knee arthroplasty (TKA). This review aimed to clarify the characteristics, accuracy, learning curve, and clinical results of robotic-assisted (RA) TKA performed using systems that are currently available in Japan (MAKO, ROSA, NAVIO/CORI, and VELYS). Methods The PubMed database was searched to identify studies on RA-TKA. Results MAKO is a semi-active robot using an oscillating saw. It is a computed tomography-based platform capable of determining the size and location of an implant pre-operatively. ROSA offers both imageless and image-based options using two-dimensional radiographs that are transformed into a three-dimensional model of the knee. NAVIO and CORI are handheld robotic platforms that support image-free anatomic data collection and streamlined intra-operative surgical planning with dynamic gap balancing. VELYS is an image-free, operating room bedrail-mounted, RA system that positions an oscillating saw for the surgeon to perform bone resection with real-time cut-plane tracking to compensate for any leg movement. Although there are some characteristic differences among the surgical assistant robots, the present review reveals that robot-controlled osteotomy may be more accurate than conventional techniques using a conventional guide and bone saw, with favorable short-term outcomes after RA-TKA. Conclusions This review found that the robotic systems recently made available in Japan demonstrate a high level of accuracy and show favorable short-term outcomes.