Robotic Joint Replacement - Robotic Joint Prosthesis Surgery
Robotic joint replacement uses a robotic arm guided by a three-dimensional CT plan of your own joint to place knee and hip implants with high precision, while the surgeon controls every step. Trials show fewer reoperations after robotic partial knee replacement and fewer misplaced hip cups. At Biruni Hospital in Istanbul, our orthopedic surgeons perform robotic total knee, partial knee and hip replacement with an enhanced recovery program and follow-up after you return home.
About This Department
A new knee or hip lasts longest when every part sits exactly where it was planned. Robotic joint replacement turns a three-dimensional plan into a precise operation.
Robotic joint replacement, also called robotic joint prosthesis surgery, uses a robotic arm guided by a three-dimensional model of your own joint to help the orthopedic surgeon prepare the bone and place the implant. The surgeon plans the size, angle and position of each component before the first cut and controls the robot throughout the operation. Precision is the main gain. In a meta-analysis of 2,485 hip replacements, robotic guidance cut the odds of a cup placed outside the safe zone by three quarters and was linked to fewer dislocations in the first year (Arun Kumar and colleagues, Journal of Robotic Surgery, 2026). In partial knee replacement, a randomized trial found no further operations at five years after robotic surgery, against 9 percent after manual surgery (Banger and colleagues, Bone and Joint Journal, 2021). This page explains how the robot works, knee, partial knee and hip replacement, what the trials show, who benefits, planning, the day of surgery, risks, recovery, and how patients from abroad arrange robotic joint replacement at Biruni Hospital in Istanbul.
What robotic joint replacement is
| Operation | What is replaced | Typical patient |
|---|---|---|
| Total knee replacement | All three compartments of the knee | Advanced arthritis of the whole knee |
| Partial knee replacement | One worn compartment | Arthritis limited to one side |
| Total hip replacement | Ball and socket of the hip | Hip arthritis, avascular necrosis |
Same implant, more precise placement
The robot does not replace the surgeon or the implant. The implants are the same proven prostheses used in conventional surgery, placed with greater accuracy.
Who performs it
Orthopedic surgeons trained in robotic joint replacement perform the operation, with anesthesia, physiotherapy and nursing teams who follow the same recovery program as for conventional surgery.
How the robot works
- A CT scan of your joint is turned into a three-dimensional model before surgery.
- The surgeon plans implant size, position and angles on that model.
- During surgery, the robot tracks the bones and lets the saw or reamer work only within the planned boundaries.
- The surgeon checks ligament balance and fine-tunes the plan before cutting.
| Step | Robotic | Conventional |
|---|---|---|
| Planning | Three-dimensional, from CT | Two-dimensional X-ray templates |
| Bone cuts | Guided within haptic boundaries | Cutting guides and jigs |
| Ligament balance | Measured and adjusted on screen | Assessed by feel |
| Implant | Same proven implants | Same proven implants |
The robot cannot move on its own. Every cut is made by the surgeon's hand on the robotic arm.
The surgeon stays in control
Technology serves judgment.
The surgeon decides the plan, confirms it against the real bone and soft tissues during the operation, moves the robotic arm, and can stop or change course at any moment, while the robot adds a level of measurement and control that the human eye and hand cannot match, so the best results come when an experienced joint replacement surgeon uses the robot as a precise tool and adjusts the plan to the patient's anatomy, ligaments and goals.
A robot in experienced hands works best.
Robotic total knee replacement
Will a robotic knee feel better than a conventional one?
| Outcome at two years | Robotic | Computer-assisted |
|---|---|---|
| Knee function score | No difference | No difference |
| Operating time | 11.5 minutes shorter | Longer |
| Injury to the posterior cruciate ligament | Less | More |
Robotic partial knee replacement
| Outcome | Robotic | Manual |
|---|---|---|
| Further surgery by five years | 0 percent | 9 percent |
| Patient-reported outcomes | Excellent | Excellent |
| Patients followed | 55 | 49 |
Robotic assistance allows partial knee replacement in more patients who would otherwise need a total knee replacement.
Robotic hip replacement
| Outcome | Effect of robotic guidance | Note |
|---|---|---|
| Cup outside the safe zone | Odds reduced by 76 percent | Odds ratio 0.24 |
| Early dislocation | Odds reduced by 62 percent | Odds ratio 0.38 |
| Leg length and offset | Closer to the plan | Better balance |
Why cup position matters
The approach
What the trials show
An honest summary
Long-term studies over ten to twenty years will show whether better accuracy translates into longer implant life, and large trials such as RACER-knee in the United Kingdom are under way.
Should I choose a hospital only because it has a robot?
Who benefits
Good candidates
Most patients who need a knee or hip replacement are suitable for robotic surgery. A CT scan is needed, which is not suitable for some patients with metal implants near the joint.
| Sign | Meaning | Next step |
|---|---|---|
| Pain at night and at rest | Advanced arthritis | Orthopedic assessment |
| Walking distance shrinking | Function limited | X-rays and examination |
| Injections and physiotherapy no longer help | Conservative care exhausted | Discussion of surgery |
Planning before surgery
Tests before surgery
| Test | Purpose | Timing |
|---|---|---|
| Standing X-rays | Alignment and arthritis | First visit |
| CT for robotic planning | Three-dimensional model | Before surgery |
| Blood tests, ECG | Fitness for anesthesia | Before surgery |
| Dental and skin check | Lower infection risk | Before surgery |
The day of surgery
A typical day
Most patients receive spinal anesthesia with sedation, which reduces nausea and allows faster recovery than general anesthesia.
| Step | Timing | Note |
|---|---|---|
| Admission | Morning | Fasting from midnight |
| Anesthesia | Spinal with sedation | General when needed |
| Surgery | One and a half to two hours | Robotic set-up included |
| First steps | Same day or next morning | With physiotherapist |
Small marker pins placed in the bone for tracking leave tiny extra marks that heal quickly.
Risks
The same risks as conventional surgery
| Risk | How we reduce it | Note |
|---|---|---|
| Infection | Antibiotics, skin preparation, laminar flow theater | Uncommon |
| Blood clots | Early walking, blood thinners, stockings | Prevention for several weeks |
| Stiffness or instability | Precise balance, physiotherapy | Robotic planning helps |
| Fracture near marker pins | Careful pin placement | Rare |
Does the CT scan add radiation?
Recovery
Physiotherapy is the most important part of recovery. The exercises you do in the first six weeks shape the final result.
| Activity | Total knee | Hip or partial knee |
|---|---|---|
| Walking without aids | Four to six weeks | Two to four weeks |
| Driving | Six weeks | Four to six weeks |
| Office work | Four to six weeks | Two to four weeks |
| Flying home | After ten to fourteen days | After seven to ten days |
Back to everyday life
Patients return to the life arthritis took away.
Walking, gardening, cycling, swimming, golf, dancing and travel become possible again for the large majority of patients, while running and contact sports are discussed individually, and modern implants last twenty years or more in registry data, with yearly or two-yearly checks and X-rays to watch for wear. Many patients with arthritis in both knees or hips have the second side done three to six months after the first.
Pain-free steps change daily life.
For patients from abroad
| Operation | Hospital stay | Total stay in Istanbul |
|---|---|---|
| Total knee replacement | Two to four days | Two weeks |
| Total hip replacement | Two to three days | Ten to fourteen days |
| Partial knee replacement | One to two days | Seven to ten days |
Fitness to fly follows the wound check and safe walking. Blood thinners continue during the flight, and we advise aisle seats and regular walks.
Support in Istanbul
Cost
We send a written quote after reviewing your X-rays, before you travel, and suggest comparing quotes for the same implant, robotic system and length of stay.
| Factor | Effect | Example |
|---|---|---|
| Joint and type | Total or partial, knee or hip | Partial knee costs less |
| Both sides | Two operations, one stay or two | Bilateral knee arthritis |
| Complexity | Deformity, previous surgery | Dysplastic hip |
References
- Banger M, Doonan J, Rowe P, Jones B, MacLean A, Blyth MJB. Robotic arm-assisted versus conventional medial unicompartmental knee arthroplasty, five-year clinical outcomes of a randomized controlled trial. Bone Joint J. 2021;103-B(6):1088-1095.
- MacDessi SJ, Wernecke GC, Ghadirinejad K, et al. Robotic-assisted surgery and functional alignment in total knee arthroplasty, the RASKAL registry-nested 2 x 2 factorial randomized trial. Bone Joint J. 2026;108-B:622-633.
- Arun Kumar G, Sharma G, Ali AFU, Arun Kumar B, Ali M. Robotic-assisted versus conventional manual total hip arthroplasty, a systematic review and meta-analysis of component position accuracy, Lewinnek zone outliers, and early dislocation rates. J Robot Surg. 2026;20(1).
- Farhan-Alanie OM, Doonan J, Rowe PJ, et al. Prospective, randomised controlled trial comparing robotic arm-assisted bi-unicompartmental knee arthroplasty to total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2025;33(7):2571-2580.
Editor's note
Written by the Biruni Hospital medical editorial team. Reviewed by Assistant Professor Şafak SAYAR, Orthopedics and Traumatology.
Medically reviewed by
Assistant Professor Şafak SAYAR
Orthopedics and Traumatology
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