Knee arthroplasty is used to treat patients with degenerative joint disease of the knee to reduce pain and restore the function of the joint. Although patient outcomes are generally quite good, there are still a number of patients that are dissatisfied with their procedures. Aside from implant design which has largely become standard, surgical technique is one of the main factors that determine clinical results. Therefore, a lot of effort has gone into improving surgical technique including the use of computer-aided surgery. The latest generation of orthopedic surgical tools involves the use of robotics to enhance the surgeons’ abilities to install implants more precisely and consistently. This review presents an evolution of robot-assisted surgical systems for knee replacement with an emphasis on the clinical results available in the literature. Ever since various robotic-assistance systems were developed and used clinically worldwide, studies have demonstrated that these systems are as safe as and more accurate than conventional methods of manual implantation. Robotic surgical assistance will likely result in improved surgical technique and improved clinical results. 1. Introduction Reconstructive knee surgery, whether unicompartmental (UKA), multicompartmental (MCKA), or total knee arthroplasty (TKA), is commonly performed on patients with end-stage osteoarthritis of the knee. Currently, there are approximately 600,000 primary TKA procedures and 45,000 primary UKA procedures performed annually in the USA . The number of procedures is growing rapidly with TKA growing at a rate of 9.4% per annum and UKA growing at a rate of 32.5% per annum in the United States . The goal of a knee arthroplasty is to restore the knee joint to a functional and pain-free state. In terms of clinical outcomes, TKA is a successful procedure when looking at pain relief and restoration of patient mobility with 10–15 years implant survival rates of greater than 90% [3–5]. Similarly, UKA has a ten-year survival rate of over 90% . However, the surgeries still need to improve in terms of patient satisfaction, especially in the case of younger patients. Patient satisfaction remains at only 82% to 89% after TKA [7–9]. Patients who received UKA are satisfied only 80–83% of the time . Additionally, for younger patients, increased implant longevity and the ability to continue an active lifestyle are strongly desired. Both the survival rate of knee arthroplasty and patient satisfaction are dependent on multiple factors including patient selection, implant design, the
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