Robotics in total hip arthroplasty: a review of the evolution, application and evidence base

Robotic systems used in orthopaedics have evolved from active systems to semi-active systems. Early active systems were associated with significant technical and surgical complications, which limited their clinical use. The new semi-active system Mako has demonstrated promise in overcoming these limitations, with positive early outcomes. There remains a paucity of data regarding long-term outcomes associated with newer systems such as Mako and TSolution One, which will be important in assessing the applicability of these systems. Given the already high satisfaction rate of manual THA, further high-quality comparative studies are required utilizing outcome scores that are not limited by high ceiling effects to assess whether robotic systems justify their additional expense.