Progress and future prospects of robot-assisted total hip arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CAI Longyao ^1,2,3 , GUI Yanxiao ^1,2,3 ,  KONG Xiangpeng ^2,3 ,  CHAI Wei ^2,3

1. School of Medicine, Nankai University, Tianjin, 300071, P. R. China;
2. Senior Department of Orthopaedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, 100048, P. R. China;
3. National Clinical Research Center for Orthopedics, Sports Medical & Rehabilitation, Beijing, 100853, P. R. China;

Corresponding?author：

KONG Xiangpeng, Email: kyggyx304@163.com; CHAI Wei, Email: chaiwei301@163.com

Keywords：

Total hip arthroplasty; robotic system; mechanical arm; domestic robot

DOI：

10.7507/1002-1892.202601099

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Total hip arthroplasty (THA) is the primary treatment for end-stage hip diseases, and its clinical outcomes mainly depend on the accuracy of prosthesis implantation. Robot-assisted THA (RTHA), with its advantages in prosthesis implantation, overcomes the uncertainty of component positioning in conventional surgery and has become a research hotspot in joint surgery in recent years. This article systematically reviews international RTHA systems such as ROBODOC and MAKO, as well as domestic RTHA systems including the ARTHROBOT Joint Replacement Surgical Robot and the LONGWELL THA Surgical Robot, comparing their technical characteristics and clinical application status. It also explores the medical application of industrial robotic arms such as WAM, KUKA, and UR and their innovative applications in THA, aiming to provide reference for the future development and clinical application of RTHA systems.

Citation： CAI Longyao, GUI Yanxiao, KONG Xiangpeng, CHAI Wei. Progress and future prospects of robot-assisted total hip arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2026, 40(6): 884-892. doi: 10.7507/1002-1892.202601099 Copy

1.	Jacofsky DJ, Allen M. Robotics in arthroplasty: A comprehensive review. J Arthroplasty, 2016, 31(10): 2353-2363.
2.	Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
3.	Callanan MC, Jarrett B, Bragdon CR, et al. The John Charnley Award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res, 2011, 469(2): 319-329.
4.	張禎, 安浩銘, 智信, 等. 國內輔助關節置換機器人的臨床應用現狀與對比. 中華骨與關節外科雜志, 2024, 17(12): 1130-1136.
5.	Iorio R, Viglietta E, Corsetti F, et al. Lewinnek zone not “the be-all and end-all” functional planning for acetabular component positioning in total hip arthroplasty. Arthroplasty, 2025, 7(1): 2. doi: 10.1186/s42836-024-00284-w.
6.	Tang H, Zhao Y, Wang S, et al. Conversion of the sagittal functional safe zone to the coronal plane using a mathematical algorithm: The reason for failure of the Lewinnek safe zone. J Bone Joint Surg (Am), 2022, 104(7): 641-648.
7.	Yang HY, Seon JK. The landscape of surgical robotics in orthopedics surgery. Biomed Eng Lett, 2023, 13(4): 537-542.
8.	Kim K, Kwon S, Kwon J, et al. A review of robotic-assisted total hip arthroplasty. Biomed Eng Lett, 2023, 13(4): 523-535.
9.	Bargar WL, Parise CA, Hankins A, et al. Fourteen year follow-up of randomized clinical trials of active robotic-assisted total hip arthroplasty. J Arthroplasty, 2018, 33(3): 810-814.
10.	Bullock EKC, Brown MJ, Clark G, et al. Robotics in total hip arthroplasty: Current concepts. J Clin Med, 2022, 11(22): 6674. doi: 10.3390/jcm11226674.
11.	Liow MHL, Chin PL, Pang HN, et al. THINK surgical TSolution-One(^?) (Robodoc) total knee arthroplasty. Sicot J, 2017, 3: 63. doi: 10.1051/sicotj/2017052.
12.	Li T, Badre A, Alambeigi F, et al. Robotic systems and navigation techniques in orthopedics: A historical review. Appl Sci, 2023, 13(17): 9768. doi: 10.3390/app13179768.
13.	張帥, 孔祥朋, 柴偉. 機器人輔助技術在全髖關節置換術中的應用現狀. 骨科, 2022, 13(1): 92-96.
14.	Loke RWK, Lim YH, Chan YK, et al. MAKO robotic-assisted compared to conventional total hip arthroplasty for hip osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res, 2025, 20(1): 466. doi: 10.1186/s13018-025-05866-1.
15.	Llombart-blanco R, Mariscal G, Barrios C, et al. MAKO robot-assisted total hip arthroplasty: a comprehensive meta-analysis of efficacy and safety outcomes. J Orthop Surg Res, 2024, 19(1): 698. doi: 10.1186/s13018-024-05199-5.
16.	Tezuka T, Heckmann ND, Bodner RJ, et al. Functional safe zone is superior to the Lewinnek safe zone for total hip arthroplasty: Why the Lewinnek safe zone is not always predictive of stability. J Arthroplasty, 2019, 34(1): 3-8.
17.	Kamath AF, Durbhakula SM, Pickering T, et al. Improved accuracy and fewer outliers with a novel CT-free robotic THA system in matched-pair analysis with manual THA. J Robot Surg, 2022, 16(4): 905-913.
18.	Chen X, Deng S, Sun ML, et al. Robotic arm-assisted arthroplasty: The latest developments. Chin J Traumatol, 2022, 25(3): 125-131.
19.	Ong CB, Buchan GBJ, Hecht CJ 2nd, et al. Robotic-assisted total hip arthroplasty utilizing a fluoroscopy-guided system produced similar cup accuracy and precision relative to a computerized tomography-based robotic platform. J Robot Surg, 2024, 18(1): 273. doi: 10.1007/s11701-024-02033-2.
20.	Buchan G, Ong C, Hecht C, et al. Equivalent radiation exposure with robotic total hip replacement using a novel, fluoroscopic-guided (CT-free) system: case-control study versus manual technique. J Robot Surg, 2023, 17(4): 1561-1567.
21.	Buchan GBJ, Bernhard Z, Hecht CJ 2nd, et al. Improved perioperative narcotic usage patterns in patients undergoing robotic-assisted compared to manual total hip arthroplasty. Arthroplasty, 2023, 5(1): 56. doi: 10.1186/s42836-023-00211-5.
22.	Wu LD, Hahne HJ, Hassenpflug J. The dimensional accuracy of preparation of femoral cavity in cementless total hip arthroplasty. J Zhejiang Univ Sci, 2004, 5(10): 1270-1278.
23.	Tian R, Duan X, Kong N, et al. Robotic-assisted total knee arthroplasty is more advantageous for knees with severe deformity: a randomized controlled trial study design. Int J Surg, 2023, 109(3): 287-296.
24.	賈若真, 韓衍龍, 王利. ARTHROBOT機器人輔助全髖置換術的早期結果. 中國矯形外科雜志, 2024, 32(9): 787-793.
25.	Tian R, Duan X, Kong N, et al. Precise acetabular positioning, discrepancy in leg length, and hip offset using a new seven-axis robot-assisted total hip arthroplasty system requires no learning curve: a retrospective study. J Orthop Surg Res, 2023, 18(1): 236. doi: 10.1186/s13018-023-03735-3.
26.	Tian R, Gao X, Kong N, et al. A new seven-axis robotic-assisted total hip arthroplasty system improves component positioning: a prospective, randomized, multicenter study. Sci Rep, 2024, 14(1): 12643. doi: 10.1038/s41598-024-63624-5.
27.	田潤, 雷雨田, 王坤正, 等. 機器人輔助人工全髖關節置換術中及術后測量髖臼角度比較研究. 中國修復重建外科雜志, 2021, 35(10): 1246-1250.
28.	Lu X, Zhang Z, Xu H, et al. A new designed full process coverage robot-assisted total hip arthroplasty: a multicentre randomized clinical trial. Int J Surg, 2024, 110(4): 2141-2150.
29.	Leiss F, G?tz JS, Meyer M, et al. Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing. Arch Orthop Trauma Surg, 2022, 142(4): 673-680.
30.	Wang W, Zhang Z, Wang G, et al. Prospective randomized controlled trial on the accuracy of prosthesis positioning in total hip arthroplasty assisted by a newly designed whole-process robotic arm. Int Orthop, 2023, 47(2): 413-419.
31.	Zhang X, Shen X, Zhang R, et al. Radiographic evaluation of robot-assisted versus manual total hip arthroplasty: a multicenter randomized controlled trial. J Orthop Traumatol, 2024, 25(1): 33. doi: 10.1186/s10195-024-00773-3.
32.	劉鐘陽, 孔祥朋, 柴偉. 國產關節置換手術機器人臨床應用現狀及展望. 骨科臨床與研究雜志, 2025, 10(1): 52-55.
33.	Lu H, Xiao Q, Xu H, et al. Robotic arm-assisted total hip arthroplasty for preoperative planning and intraoperative decision-making. J Orthop Surg Res, 2023, 18(1): 608. doi: 10.1186/s13018-023-04095-8.
34.	Sun H, Lu H, Xiao Q, et al. The learning curve of a novel seven-axis robot-assisted total hip arthroplasty system: a randomized controlled trial. Bmc Musculoskelet Disord, 2024, 25(1): 342. doi: 10.1186/s12891-024-07474-2.
35.	Lu H, Sun H, Xiao Q, et al. Perioperative safety and efficacy of robot-assisted total hip arthroplasty in ERAS-managed patients: a pilot study. J Orthop Surg Res, 2023, 18(1): 696. doi: 10.1186/s13018-023-04180-y.
36.	張帥, 孔祥朋, 柴偉. 2021年度關節外科手術機器人臨床應用盤點. 骨科, 2022, 13(6): 562-567.
37.	Xu Z, Chai S, Chen D, et al. The LANCET robotic system can improve surgical efficiency in total hip arthroplasty: A prospective randomized, multicenter, parallel-controlled clinical trial. J Orthop Translat, 2024, 45: 247-255.
38.	Hiltzik DM, Cin MD, Hamama BA, et al. Comparison of pelvic landmarks for leg length discrepancy measurement with robotic arm-assisted total hip arthroplasty. Arthroplast Today, 2023, 24: 101252. doi: 10.1016/j.artd.2023.101252.
39.	Geng X, Dong Z, Li Y, et al. Precise acetabular prosthesis positioning using a novel robot-assisted total hip arthroplasty system: A multicenter, randomized controlled trial. Orthop Surg, 2025, 17(1): 141-150.
40.	陶子航. 輕型機械臂結構及控制系統的設計研究. 合肥: 中國科學技術大學, 2017.
41.	張含陽. 人機協作: 下一代機器人的必然屬性. 機器人產業, 2016, (3): 37-45.
42.	強歡. 六自由度機械臂關節模塊化技術研究. 北京: 北京理工大學, 2015.
43.	Li T, Walker P, Khonasty R, et al. Robotic-assisted burring in total hip replacement: A new surgical technique to optimise acetabular preparation. Int J Med Robot, 2024, 20(1): e2615. doi: 10.1002/rcs.2615.
44.	Jevnikar BE, Khan ST, Emara AK, et al. Robotic total hip and knee arthroplasty: economic impact and workflow efficiency. J Robot Surg, 2025, 19(1): 578. doi: 10.1007/s11701-025-02698-3.
45.	Domb BG, Quesada-jimenez R, Barda SR, et al. Ten-year functional outcomes following robotic-assisted total hip arthroplasty: A case series. J Arthroplasty, 2026. doi: 10.1016/j.arth.2026.01.052.
46.	Ron I, Shapira J, Kahana-rojkind AH, et al. Comparison of patient-reported outcome measures between robotic-assisted and manual total hip arthroplasty: A systematic review with a minimum 2-year follow-up. J Clin Med, 2025, 14(17): 6036. doi: 10.3390/jcm14176036.
47.	Ruangsomboon P, Ruangsomboon O, Osman K, et al. Clinical, functional, and radiological outcomes of robotic assisted versus conventional total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Robot Surg, 2024, 18(1): 255. doi: 10.1007/s11701-024-01949-z.

1. Jacofsky DJ, Allen M. Robotics in arthroplasty: A comprehensive review. J Arthroplasty, 2016, 31(10): 2353-2363.
2. Lewinnek GE, Lewis JL, Tarr R, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg (Am), 1978, 60(2): 217-220.
3. Callanan MC, Jarrett B, Bragdon CR, et al. The John Charnley Award: risk factors for cup malpositioning: quality improvement through a joint registry at a tertiary hospital. Clin Orthop Relat Res, 2011, 469(2): 319-329.
4. 張禎, 安浩銘, 智信, 等. 國內輔助關節置換機器人的臨床應用現狀與對比. 中華骨與關節外科雜志, 2024, 17(12): 1130-1136.
5. Iorio R, Viglietta E, Corsetti F, et al. Lewinnek zone not “the be-all and end-all” functional planning for acetabular component positioning in total hip arthroplasty. Arthroplasty, 2025, 7(1): 2. doi: 10.1186/s42836-024-00284-w.
6. Tang H, Zhao Y, Wang S, et al. Conversion of the sagittal functional safe zone to the coronal plane using a mathematical algorithm: The reason for failure of the Lewinnek safe zone. J Bone Joint Surg (Am), 2022, 104(7): 641-648.
7. Yang HY, Seon JK. The landscape of surgical robotics in orthopedics surgery. Biomed Eng Lett, 2023, 13(4): 537-542.
8. Kim K, Kwon S, Kwon J, et al. A review of robotic-assisted total hip arthroplasty. Biomed Eng Lett, 2023, 13(4): 523-535.
9. Bargar WL, Parise CA, Hankins A, et al. Fourteen year follow-up of randomized clinical trials of active robotic-assisted total hip arthroplasty. J Arthroplasty, 2018, 33(3): 810-814.
10. Bullock EKC, Brown MJ, Clark G, et al. Robotics in total hip arthroplasty: Current concepts. J Clin Med, 2022, 11(22): 6674. doi: 10.3390/jcm11226674.
11. Liow MHL, Chin PL, Pang HN, et al. THINK surgical TSolution-One(^?) (Robodoc) total knee arthroplasty. Sicot J, 2017, 3: 63. doi: 10.1051/sicotj/2017052.
12. Li T, Badre A, Alambeigi F, et al. Robotic systems and navigation techniques in orthopedics: A historical review. Appl Sci, 2023, 13(17): 9768. doi: 10.3390/app13179768.
13. 張帥, 孔祥朋, 柴偉. 機器人輔助技術在全髖關節置換術中的應用現狀. 骨科, 2022, 13(1): 92-96.
14. Loke RWK, Lim YH, Chan YK, et al. MAKO robotic-assisted compared to conventional total hip arthroplasty for hip osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res, 2025, 20(1): 466. doi: 10.1186/s13018-025-05866-1.
15. Llombart-blanco R, Mariscal G, Barrios C, et al. MAKO robot-assisted total hip arthroplasty: a comprehensive meta-analysis of efficacy and safety outcomes. J Orthop Surg Res, 2024, 19(1): 698. doi: 10.1186/s13018-024-05199-5.
16. Tezuka T, Heckmann ND, Bodner RJ, et al. Functional safe zone is superior to the Lewinnek safe zone for total hip arthroplasty: Why the Lewinnek safe zone is not always predictive of stability. J Arthroplasty, 2019, 34(1): 3-8.
17. Kamath AF, Durbhakula SM, Pickering T, et al. Improved accuracy and fewer outliers with a novel CT-free robotic THA system in matched-pair analysis with manual THA. J Robot Surg, 2022, 16(4): 905-913.
18. Chen X, Deng S, Sun ML, et al. Robotic arm-assisted arthroplasty: The latest developments. Chin J Traumatol, 2022, 25(3): 125-131.
19. Ong CB, Buchan GBJ, Hecht CJ 2nd, et al. Robotic-assisted total hip arthroplasty utilizing a fluoroscopy-guided system produced similar cup accuracy and precision relative to a computerized tomography-based robotic platform. J Robot Surg, 2024, 18(1): 273. doi: 10.1007/s11701-024-02033-2.
20. Buchan G, Ong C, Hecht C, et al. Equivalent radiation exposure with robotic total hip replacement using a novel, fluoroscopic-guided (CT-free) system: case-control study versus manual technique. J Robot Surg, 2023, 17(4): 1561-1567.
21. Buchan GBJ, Bernhard Z, Hecht CJ 2nd, et al. Improved perioperative narcotic usage patterns in patients undergoing robotic-assisted compared to manual total hip arthroplasty. Arthroplasty, 2023, 5(1): 56. doi: 10.1186/s42836-023-00211-5.
22. Wu LD, Hahne HJ, Hassenpflug J. The dimensional accuracy of preparation of femoral cavity in cementless total hip arthroplasty. J Zhejiang Univ Sci, 2004, 5(10): 1270-1278.
23. Tian R, Duan X, Kong N, et al. Robotic-assisted total knee arthroplasty is more advantageous for knees with severe deformity: a randomized controlled trial study design. Int J Surg, 2023, 109(3): 287-296.
24. 賈若真, 韓衍龍, 王利. ARTHROBOT機器人輔助全髖置換術的早期結果. 中國矯形外科雜志, 2024, 32(9): 787-793.
25. Tian R, Duan X, Kong N, et al. Precise acetabular positioning, discrepancy in leg length, and hip offset using a new seven-axis robot-assisted total hip arthroplasty system requires no learning curve: a retrospective study. J Orthop Surg Res, 2023, 18(1): 236. doi: 10.1186/s13018-023-03735-3.
26. Tian R, Gao X, Kong N, et al. A new seven-axis robotic-assisted total hip arthroplasty system improves component positioning: a prospective, randomized, multicenter study. Sci Rep, 2024, 14(1): 12643. doi: 10.1038/s41598-024-63624-5.
27. 田潤, 雷雨田, 王坤正, 等. 機器人輔助人工全髖關節置換術中及術后測量髖臼角度比較研究. 中國修復重建外科雜志, 2021, 35(10): 1246-1250.
28. Lu X, Zhang Z, Xu H, et al. A new designed full process coverage robot-assisted total hip arthroplasty: a multicentre randomized clinical trial. Int J Surg, 2024, 110(4): 2141-2150.
29. Leiss F, G?tz JS, Meyer M, et al. Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing. Arch Orthop Trauma Surg, 2022, 142(4): 673-680.
30. Wang W, Zhang Z, Wang G, et al. Prospective randomized controlled trial on the accuracy of prosthesis positioning in total hip arthroplasty assisted by a newly designed whole-process robotic arm. Int Orthop, 2023, 47(2): 413-419.
31. Zhang X, Shen X, Zhang R, et al. Radiographic evaluation of robot-assisted versus manual total hip arthroplasty: a multicenter randomized controlled trial. J Orthop Traumatol, 2024, 25(1): 33. doi: 10.1186/s10195-024-00773-3.
32. 劉鐘陽, 孔祥朋, 柴偉. 國產關節置換手術機器人臨床應用現狀及展望. 骨科臨床與研究雜志, 2025, 10(1): 52-55.
33. Lu H, Xiao Q, Xu H, et al. Robotic arm-assisted total hip arthroplasty for preoperative planning and intraoperative decision-making. J Orthop Surg Res, 2023, 18(1): 608. doi: 10.1186/s13018-023-04095-8.
34. Sun H, Lu H, Xiao Q, et al. The learning curve of a novel seven-axis robot-assisted total hip arthroplasty system: a randomized controlled trial. Bmc Musculoskelet Disord, 2024, 25(1): 342. doi: 10.1186/s12891-024-07474-2.
35. Lu H, Sun H, Xiao Q, et al. Perioperative safety and efficacy of robot-assisted total hip arthroplasty in ERAS-managed patients: a pilot study. J Orthop Surg Res, 2023, 18(1): 696. doi: 10.1186/s13018-023-04180-y.
36. 張帥, 孔祥朋, 柴偉. 2021年度關節外科手術機器人臨床應用盤點. 骨科, 2022, 13(6): 562-567.
37. Xu Z, Chai S, Chen D, et al. The LANCET robotic system can improve surgical efficiency in total hip arthroplasty: A prospective randomized, multicenter, parallel-controlled clinical trial. J Orthop Translat, 2024, 45: 247-255.
38. Hiltzik DM, Cin MD, Hamama BA, et al. Comparison of pelvic landmarks for leg length discrepancy measurement with robotic arm-assisted total hip arthroplasty. Arthroplast Today, 2023, 24: 101252. doi: 10.1016/j.artd.2023.101252.
39. Geng X, Dong Z, Li Y, et al. Precise acetabular prosthesis positioning using a novel robot-assisted total hip arthroplasty system: A multicenter, randomized controlled trial. Orthop Surg, 2025, 17(1): 141-150.
40. 陶子航. 輕型機械臂結構及控制系統的設計研究. 合肥: 中國科學技術大學, 2017.
41. 張含陽. 人機協作: 下一代機器人的必然屬性. 機器人產業, 2016, (3): 37-45.
42. 強歡. 六自由度機械臂關節模塊化技術研究. 北京: 北京理工大學, 2015.
43. Li T, Walker P, Khonasty R, et al. Robotic-assisted burring in total hip replacement: A new surgical technique to optimise acetabular preparation. Int J Med Robot, 2024, 20(1): e2615. doi: 10.1002/rcs.2615.
44. Jevnikar BE, Khan ST, Emara AK, et al. Robotic total hip and knee arthroplasty: economic impact and workflow efficiency. J Robot Surg, 2025, 19(1): 578. doi: 10.1007/s11701-025-02698-3.
45. Domb BG, Quesada-jimenez R, Barda SR, et al. Ten-year functional outcomes following robotic-assisted total hip arthroplasty: A case series. J Arthroplasty, 2026. doi: 10.1016/j.arth.2026.01.052.
46. Ron I, Shapira J, Kahana-rojkind AH, et al. Comparison of patient-reported outcome measures between robotic-assisted and manual total hip arthroplasty: A systematic review with a minimum 2-year follow-up. J Clin Med, 2025, 14(17): 6036. doi: 10.3390/jcm14176036.
47. Ruangsomboon P, Ruangsomboon O, Osman K, et al. Clinical, functional, and radiological outcomes of robotic assisted versus conventional total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Robot Surg, 2024, 18(1): 255. doi: 10.1007/s11701-024-01949-z.

Previous Article
Interpretation of the Expert Consensus Statement on the Role of Vitamin D in Metabolic Health
Next Article
Diabetic foot care: full-lifecycle management driven by digital intelligent technologies

Chinese Journal of Reparative and Reconstructive Surgery

Progress and future prospects of robot-assisted total hip arthroplasty

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content