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
Orthopedics
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.
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Percent reoperations at five years after robotic partial knee replacement in a randomized trial, against 9 percent manual
76
Percent lower odds of a misplaced hip cup with robotic guidance
3D
Plan of your own joint made from CT before surgery
Free
Review of your X-rays and symptoms by our orthopedic team
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.
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Why accuracy matters
Small errors in angle or position change how the joint moves, how the ligaments are balanced and how the implant wears over the years.
Robotic systems have been used in joint replacement for over a decade and are now part of routine practice in many large orthopedic centers.
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.
Robotic against conventional technique
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
Haptic boundaries stop the cutting tool at the planned edge, which protects ligaments and soft tissues around the joint.
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?
Large randomized trials have not shown clear differences in pain and function scores at two years between robotic and conventional or computer-navigated total knee replacement. The robot gives more precise and reproducible bone cuts and ligament balance, which may matter most for implant survival over the long term.
Robotic against computer-assisted total knee replacement, RASKAL trial, 303 patients
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
The RASKAL trial in Australia found that robotic surgery protected the soft tissues better and took less time than computer navigation, with similar patient-reported results (MacDessi and colleagues, Bone and Joint Journal, 2026).
Robotic partial knee replacement
Five-year randomized trial of partial knee replacement
Outcome
Robotic
Manual
Further surgery by five years
0 percent
9 percent
Patient-reported outcomes
Excellent
Excellent
Patients followed
55
49
Partial knee replacement replaces only the worn compartment and keeps the healthy bone and the cruciate ligaments, so the knee feels more natural. It is a precise operation, sensitive to small alignment errors, and this is where robotic assistance shows its clearest benefit (Banger and colleagues, 2021).
Robotic assistance allows partial knee replacement in more patients who would otherwise need a total knee replacement.
When both the inner and front compartments are worn, two partial replacements can be placed with the robot, keeping the cruciate ligaments. A randomized trial found results similar to total knee replacement at two years (Farhan-Alanie and colleagues, Knee Surgery Sports Traumatology Arthroscopy, 2025).
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Faster early recovery
Smaller incision, less blood loss, quicker walking.
Robotic hip replacement
Hip replacement with and without robotic guidance, 15 studies, 2,485 operations
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
The hip socket must face the right direction to prevent dislocation and uneven wear. The robot places the cup at the planned angle and restores leg length and hip offset, so the new hip feels balanced (Arun Kumar and colleagues, 2026).
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Complex hips
Robotic planning helps in hips deformed by childhood hip dysplasia, previous fractures or surgery, where normal landmarks are lost.
What the trials show
An honest summary
Robotic surgery consistently improves the accuracy of implant placement and reduces outliers. Its effect on how patients feel in the first years is smaller, and randomized trials of total knee replacement show similar patient-reported scores to conventional surgery.
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Where benefits are clearest
Partial knee replacement, with fewer reoperations, and hip replacement, with fewer misplaced cups and early dislocations.
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?
The surgeon's experience matters most, with the robot as a tool. Choose a team that performs many joint replacements each year, uses the robot routinely and follows an enhanced recovery program.
Both techniques relieve pain well.
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.
Patients with deformity, previous fractures, hip dysplasia or arthritis limited to one compartment of the knee gain the most from robotic planning.
When to consider joint replacement
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
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CT-based plan
A low-dose CT scan of the joint is taken one to four weeks before surgery, and the surgeon builds your personal plan.
Tests before surgery
Before robotic joint replacement
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
Diabetes, anemia and weight are optimized before surgery, because they affect healing and infection risk. Smokers are advised to stop at least four weeks before.
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Prehabilitation
Exercises before surgery strengthen the muscles and speed recovery afterward.
The day of surgery
A typical day
Most patients receive spinal anesthesia with sedation, which reduces nausea and allows faster recovery than general anesthesia.
Your day of surgery
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
Local anesthetic injected around the joint during surgery controls pain in the first hours, and tranexamic acid reduces blood loss, so drains and transfusions are rarely needed.
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Hospital stay
Two to four days for total knee and hip replacement, one to two days for partial knee replacement.
Small marker pins placed in the bone for tracking leave tiny extra marks that heal quickly.
Robotic surgery does not remove the general risks of joint replacement. It reduces errors in implant position, which are a cause of later instability, wear and revision.
Does the CT scan add radiation?
Yes, a small dose. The planning CT uses a low-dose protocol limited to the joint, a fraction of a standard abdominal CT.
Recovery
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Walking from day one
Patients walk with a frame or crutches on the day of surgery or the next morning, and climb stairs before going home.
Physiotherapy is the most important part of recovery. The exercises you do in the first six weeks shape the final result.
Pain and swelling settle over six to twelve weeks for a total knee and faster for a hip or partial knee. Full recovery continues for up to a year.
Recovery timeline
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
Typical stay in Istanbul
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.
Send recent standing X-rays of the joint, a list of medicines and any previous operation notes. Our orthopedic team reviews them and confirms suitability before you travel. The planning CT is done in Istanbul.
Support in Istanbul
One coordinator from the international patients office handles arrangements from the first message through discharge and answers the same WhatsApp number after you return. The office works in English, Arabic, French, Russian, Serbian, Romanian and Spanish and books interpreters for other languages, and it arranges the visa invitation letter, airport transfers, daily transport and accommodation near the hospital. Halal, vegetarian and diabetic meals, a prayer room on site, and a female physician on request wherever the rota allows.
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After you return home
Physiotherapy continues with a local therapist using our written program, and we review your progress and X-rays by video at six weeks and three months.
Cost
The quote includes the planning CT, robotic surgery, the implant, the hospital stay, inpatient physiotherapy and medicines at discharge. Implant brand and type, and the need for both sides, change the price.
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.
What changes the quote
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 Assoc. Prof. Dr. Suat BATAR, Orthopedics and Traumatology.
