This systematic review and meta-analysis of 17 studies evaluates semi-active (MAKO) robotic arm-assisted THA versus manual THA. It addresses four questions: learning curve, acetabular positioning accuracy, functional outcomes, and complication and revision rates. All 17 included studies were retrospective or prospective observational — no RCTs exist.
Accurate cup placement and freedom from dislocation are not synonymous — this paper makes that distinction concrete.
When a patient or administrator asks whether robotic THA is worth the cost, the honest answer from current evidence is: it consistently places the cup in the safe zone, but that advantage has not yet translated into fewer dislocations, fewer revisions, or a clinically meaningful functional gain at short-term follow-up.
In practice, use this paper to set expectations around the learning curve: budget for 12–14 cases of longer operating time when starting a robotic THA program, but reassure your team that cup positioning will be accurate from the first case.
If you are assessing functional outcomes in robotic THA patients, consider the Forgotten Joint Score rather than the Harris Hip Score. The HHS ceiling effect may obscure real differences that a 20-point FJS gap would reveal. The field still needs a well-powered RCT with mid-term follow-up and cost data before robotic THA can be recommended on an evidence-based outcomes argument alone.
This systematic review and meta-analysis of 17 studies evaluates semi-active (MAKO) robotic arm-assisted THA versus manual THA. It addresses four questions: learning curve, acetabular positioning accuracy, functional outcomes, and complication and revision rates. All 17 included studies were retrospective or prospective observational — no RCTs exist.
Accurate cup placement and freedom from dislocation are not synonymous — this paper makes that distinction concrete.
When a patient or administrator asks whether robotic THA is worth the cost, the honest answer from current evidence is: it consistently places the cup in the safe zone, but that advantage has not yet translated into fewer dislocations, fewer revisions, or a clinically meaningful functional gain at short-term follow-up.
In practice, use this paper to set expectations around the learning curve: budget for 12–14 cases of longer operating time when starting a robotic THA program, but reassure your team that cup positioning will be accurate from the first case.
If you are assessing functional outcomes in robotic THA patients, consider the Forgotten Joint Score rather than the Harris Hip Score. The HHS ceiling effect may obscure real differences that a 20-point FJS gap would reveal. The field still needs a well-powered RCT with mid-term follow-up and cost data before robotic THA can be recommended on an evidence-based outcomes argument alone.