Value proposition of robotic total knee arthroplasty: what can robotic technology deliver in 2018 and beyond?

INTRODUCTION: Robotic-assisted total knee arthroplasty (TKA) has undergone marked development and increasingly gained interest with multiple studies demonstrating excellent clinical and radiographic outcomes. However, a value assessment that encompasses other aspects related to the adoption of this technology is necessary to fully appreciate the cost/benefit ratio and potential present and future returns. Due to the relative paucity of evidence, this review was conducted to compare newer generation robotic TKA systems vs. historic ones and we evaluated: 1) clinical outcomes; 2) radiographic outcomes; 3) safety; 4) learning curve; 5) operating room efficiency; 6) effect on ergonomic health; and 7) cost analysis of robotic - assisted TKA to understand their value proposition. Areas covered: Comprehensive and detailed discussion of past and contemporary robotic-arm assisted TKA systems. What are the clinical and radiological outcomes and how robotic systems have evolved to offer potential advantages in 2018. Expert commentary: Robotic systems for TKA have undergone substantial development with proven excellent clinical and radiographic outcomes. However, there are still limitations to overcome. Overall, recent robotic technology is on a steep curve of adoption and expected only to grow, backed by the demonstrated clinical success and cost - benefit value that is projected to favor further growth.