Independent, sourced patient educationInformedSurgery
Hip Replacement Explained
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All topics
  1. What it is
  2. Who it helps
  3. Timing
  4. The procedure
  5. What a hemiarthroplasty is
  6. Hemi vs total hip
  7. Recovery after hip fracture
  8. Patient journey
  9. Recovery supplies
  10. Finding a surgeon
  11. Insurance and costs
  12. Questions to ask
  13. Implant designs
  14. Side-by-side
  15. Robotics and navigation
  16. US manufacturers
  17. What the evidence says
  18. Value analysis
  19. Resources
  20. Glossary
  21. References

Technology

Robotics and navigation

In hip replacement, the hardest thing to get exactly right is the angle of the cup in the pelvis, along with leg length and offset. Several technologies help with this:

  • Robotic arms use a CT scan or X-rays to make a plan, then guide or limit the surgeon's instruments as the socket is shaped and the cup is placed.
  • Navigation tracks instruments or analyzes X-rays during surgery and shows angles and leg length on a screen.
  • Augmented reality shows the same kind of guidance in a headset in the surgeon's line of sight.

In every case the surgeon still performs the operation.

What the research shows

A 2026 meta-analysis of 15 studies (2,485 hips) found that robotic surgery placed fewer cups outside the target range and had fewer dislocations in the first year.21 That's promising, but most included studies were not randomized, and there is not yet good evidence that robotics makes hips last longer or feel better years later. A 2026 review of technology in anterior-approach surgery reached a similarly cautious conclusion.22

Good results are common without robotics too. Ask your surgeon how they get consistent cup placement, whatever tools they use.

Clinical detail
  • Robotic vs manual THA (15 studies, 2,485 procedures): Lewinnek zone outliers OR 0.24 (95% CI 0.16 to 0.36); early dislocation OR 0.38 (95% CI 0.20 to 0.73). Mixed RCT and observational evidence.21
Value analysis

Robotic platforms involve capital or placement agreements, disposables, imaging and set-up time. A systematic review found most health-economic studies of CT-based robotic-arm arthroplasty reported lower 90-day episode costs, but it had industry co-authors, so weigh it accordingly.23 Ask vendors for implant-agnostic data and track your own utilization and episode costs.

Sources for this page

  1. Arun Kumar G, et al. 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). doi:10.1007/s11701-026-03678-x
  2. Jha G, et al. Beyond robotics: a systematic review of technology integration in direct anterior approach total hip arthroplasty. J Robot Surg. 2026;20(1). doi:10.1007/s11701-026-03485-4
  3. Sarrel K, et al. Understanding economic analysis and cost-effectiveness of CT scan-guided, 3-dimensional, robotic-arm assisted lower extremity arthroplasty: a systematic review. J Comp Eff Res. 2024;13(4):e230040. Industry co-authors. doi:10.57264/cer-2023-0040

All references