New technology should earn its place through meaningful results for patients. Dr. Kurt Hirshorn evaluates robotic assistance by its effect on outcomes, operating time and cost.
Dr. Hirshorn is committed to providing state-of-the-art hip and knee replacement while balancing the substantial costs of new technology that has not established consistent clinical superiority.
His goal is to provide the highest-quality, data- and results-oriented care possible while remaining mindful of skyrocketing healthcare costs. Until robotics has clear scientific evidence of a meaningful advantage for his patients, Dr. Hirshorn has chosen a wait-and-see approach.
Robotic assistance is a tool used by the surgeon during parts of a hip or knee replacement. The surgeon remains responsible for the operation; the robot does not independently perform the surgery.
A consistent, clinically meaningful superiority of robotic-assisted hip and knee replacement over well-performed conventional surgery has not been established across patients and settings. Several recent studies report similar patient-reported outcomes. The research is mixed, however, and some analyses report differences in selected outcomes. This is not proof that every technique is identical or that no patient could benefit.
Long-term pain relief, function, satisfaction and the need for another operation matter more than the technology label. Evidence should be assessed by robotic system, study design, patient group and duration of follow-up.
A review of 31 randomized studies involving 4,086 participants found broadly comparable patient-reported, functional and safety outcomes. Robotic procedures took about 21 minutes longer on average. The authors did not find consistent broad clinical superiority; evidence certainty varied. Read the study.
A GRADE-assessed meta-analysis of randomized trials concluded that robotic assistance did not confer clinically meaningful advantages in pain relief, functional improvement or patient satisfaction. It reported approximately 22 minutes of additional operating time. Read the study.
A meta-analysis of semi-active robotic systems found no significant differences in WOMAC or Harris Hip Score clinical measures, hospital stay or blood loss. Conventional surgery had a shorter operating duration. These findings apply to the systems and trials included, rather than every robotic platform. Read the study.
A review of 25 randomized trials involving 3,156 patients found similar postoperative clinical scores and longer robotic operating times, averaging about 22 additional minutes. Read the study.
Robotic systems add equipment, maintenance, disposable-instrument and training costs. Longer procedures can also consume more operating-room resources. The effect on total episode cost depends on contracts, case volume, workflow and the healthcare setting; robotic surgery is not uniformly more expensive in every cost analysis.
A hip-replacement costing study published in January 2026 found higher unadjusted supply and facility costs for robotic cases, but no statistically significant difference in total facility costs after adjustment for patient factors. Operating times were similar in that study. These findings underscore why costs and time cannot be described as universally higher. Read the cost study.
Technology adoption is not driven only by clinical evidence. Commercial influences may include the following; they do not establish the motivation of an individual surgeon.
Further reading: Robots on the Stage: the American robotic knee replacement market (2024); Robotic knee replacement marketing and the literature (2024).
Training, judgment and repeated experience matter. Higher surgeon volume is associated with better outcomes in many studies, although volume alone is not a guarantee of quality. 2026 hip replacement volume review.
Addressing diabetes control, nutrition, smoking, medical conditions and strength before surgery can help reduce risk and support recovery. Preparation is tailored to your health.
Implants should suit the patient and have evidence supporting their performance and durability. A new product is not automatically a better product.
Careful handling of muscles, tendons and ligaments, together with attention to joint stability and balance, is an important part of the surgical plan.
Dr. Hirshorn can explain his approach, the evidence behind it and the treatment plan that fits your needs.
Schedule an appointmentEvidence reviewed October 4, 2026. Study findings may change as additional research becomes available.