Robotic orthopaedic technology

In brief

• Robotic orthopaedics combines several approaches to planning, navigation and tool control.
• CT-based and imageless describe how anatomical data are obtained; they are not quality scores.
• Registration connects patient anatomy to a digital model, while navigation tracks movement.
• The surgeon approves the plan and controls its execution regardless of the platform’s automation level.

From anatomical data to a plan

In a CT-based workflow, preoperative computed tomography is used to build a 3D model. Component size and position, landmarks and bone-preparation parameters can then be planned. MAKO and CUVIS-joint use this approach in the configurations described in their source records.

Imageless platforms build a model from landmarks acquired during surgery. CORI maps bone surfaces; VELYS uses optical tracking to collect anatomical points; ROSA Knee supports imageless and image-based modes. ROSA’s image-based workflow uses compatible radiographic data and should not be conflated with MAKO’s CT-based process.

Neither route removes the need to validate input quality. Registration error, movement of a tracking array or inappropriate interpretation can affect the digital representation.

Registration, navigation and tools

Registration establishes the relationship between physical points and the system’s coordinates. Navigation then displays the position of anatomy, components or instruments. Cameras and markers provide measurements; they do not determine the clinical objective.

The same “robotic arm” label conceals different functions. MAKO constrains an arm-mounted instrument. ROSA Knee positions a cutting guide. VELYS controls the orientation of a surgeon-held saw within a permitted plane. CUVIS performs automated resection under surgeon direction. CORI uses a handheld burr without a separate positioning arm.

A haptic boundary is a software-defined interaction zone between the tool and the plan. It can constrain movement or cutting action, but it does not guarantee that injury is impossible and never replaces surgical oversight.

Balancing, positioning and alignment

Platforms may display joint gaps, limb position and the predicted effect of plan changes. These functions support soft-tissue assessment and alignment strategy—the spatial goals for component placement. The system supplies measurements and constraints; the surgeon selects a clinically acceptable target.

Close execution of the plan is a technical endpoint. Patient benefit must be studied separately through pain, function, adverse events, reoperation and implant-survival outcomes over suitable follow-up.

Read How robotic joint replacement works for the full sequence and Robot versus surgeon for the responsibility boundary.

This material is for information and education only and is not a substitute for medical consultation. Diagnostic and treatment decisions must be made individually with a qualified healthcare professional.