Is robotic knee replacement better than conventional surgery?
Robotic systems can improve the precision of implant alignment and execution of a pre-operative plan. However, the most important current UK randomised evidence did not provide a clinically meaningful patient benefit at one year.
What did the RACER-Knee trial find?
RACER-Knee was a pragmatic multicentre UK randomised controlled trial comparing MAKO robotic-arm-assisted total knee replacement with conventional instruments. At 12 months, the main patient-reported outcome was very similar between groups. Serious adverse events were also similar, while robotic surgery was more costly.
The trial does not mean robotics has no value; it means the value should be described accurately — particularly in planning and precision — rather than as a guarantee of better pain or function.
Who may be suitable?
Suitability depends on the pattern of arthritis, the planned procedure, implant requirements and individual anatomy. A consultation first establishes whether knee replacement itself is appropriate and then whether robotic assistance adds value.
Does the robot make decisions?
No. The surgeon remains in control throughout. The system is an assistive tool that operates within parameters defined and monitored by the surgeon.
