Robotic-Assisted Total Knee Replacement

Overview

Robotic-assisted total knee replacement uses a robotic arm to place implant components with more precision than manual instrumentation. Dr. Raffo has performed 30 to 40 robotic knee replacements a year for 15 years. Robotics clearly improves alignment accuracy, but hasn't been shown to improve patient-reported outcomes or implant survival over conventional technique — and this page says so directly.

How Dr. Raffo Performs This Procedure

Robotic-assisted total knee replacement begins with preoperative imaging or intraoperative registration that builds a three-dimensional model of the patient's knee. During surgery, the robotic system guides bone preparation within a planned envelope, and soft-tissue balance is checked and adjusted in real time before final implant placement. The mechanics of implanting the components — femoral, tibial, and patellar as needed — are the same as conventional total knee replacement; what differs is the precision and real-time feedback available to the surgeon while positioning them. Robotic systems do add operative time compared to conventional instrumentation, on the order of 9 to 18 minutes depending on how the comparison is defined (Hoeffel et al. 2023; Bensa et al. 2023).

Who Is This For?

Robotic-assisted total knee replacement is appropriate for the same patients who are candidates for conventional total knee replacement: those with advanced, symptomatic osteoarthritis or other degenerative joint disease affecting the whole knee, where cartilage-preserving options are no longer viable. It is not a treatment for a focal cartilage defect in an otherwise healthy joint — that population is better served by the cartilage restoration techniques discussed on the cartilage repair hub. Robotic assistance itself does not change who is a candidate for knee replacement; it changes how the surgery is executed once that decision has been made.

Recovery & Rehabilitation

Recovery from robotic-assisted total knee replacement follows the same general arc as conventional replacement, with the recovery-related benefits robotics has actually demonstrated concentrated in the early postoperative period.

• 0–2 weeks: Early mobilization begins immediately; robotic TKA is associated with a 14% reduction in length of stay and higher odds of discharge directly home rather than to a facility (Hoeffel et al. 2023).
• 2–6 weeks: Progressive weight-bearing, gait training, and range-of-motion therapy.
• 6–12 weeks: Most patients resume most daily activities; formal physical therapy continues.
• 3–6 months: Continued strength and endurance gains; return-to-sport assessment for active patients begins in this window.
• 1 year and beyond: In a large prospective cohort of TKA patients who were athletes before surgery, 53.4% achieved return to sport by 1 year, with a median time to return of 12 weeks and 90% returning within 27 weeks (Soares et al. 2026).