Robotic knee replacement
Dr Jason Tsung uses the Stryker Mako robotic-arm system for total and partial knee replacement, and has done so since 2016. The robot doesn't perform the surgery. Dr Tsung does. It is a guidance tool that helps him position your new knee to a plan built around your own anatomy.
Written and reviewed by Dr Jason Tsung, FRACS (Orth) · Last reviewed June 2026
What robotic-assisted knee replacement involves
Robotic-assisted knee replacement is conventional knee replacement carried out with the help of a robotic-arm system, with the surgeon in control throughout. A low-dose CT scan taken before surgery is turned into a 3D model of your knee, the implant is planned onto that model, and during the operation the robotic arm helps Dr Tsung follow the plan precisely and keeps the instrument within the planned area. There is more detail on how the Mako system works, step by step, on the robotic-assisted joint replacement page.
Precision in knee replacement
The best-proven benefit of robotic assistance is precision: placing the implant more accurately, and more consistently, than manual technique. In knee replacement, pooled randomised trials found robotic assistance reduced the chance of an implant falling outside the target alignment by about two-thirds.¹
In the knee, that precision is used to deliver a functional alignment plan, positioning the implant to suit your knee's own shape and ligament balance rather than fitting every knee to one textbook target. Only about one in seven people have the neutral, straight-line alignment older techniques were built around, and robotic planning makes a tailored approach repeatable, with fewer alignment outliers than manual technique.
What the evidence shows
Early recovery: modest, mostly short-term. Some studies report that, in the first days and weeks, patients having robotic knee replacement may have less pain, use fewer opioid painkillers, and go home a little sooner than with manual surgery.²,³ These differences are real but modest, and tend to even out over the following months.
Function: small early gains. Some pooled studies suggest modestly better knee function in the first months to a year,⁴ and a randomised trial found greater improvement in knee pain over the first year, though not in overall function or quality of life.⁵
Long-term results: similar to conventional surgery. National joint replacement registries and recent reviews have not shown that robotic assistance makes a knee replacement last longer, or need fewer revisions, than well-performed conventional surgery.⁶,⁷ Precision is the proven benefit. The current evidence doesn't show a guaranteed difference in the long-term result.
Robotic partial (unicompartmental) knee replacement
Partial knee replacement resurfaces only the worn compartment of the knee. It is technically demanding and less forgiving of small positioning errors, which is where robotic precision may matter most. A 2026 review of nearly 9,000 partial knee replacements found fewer alignment outliers with robotic assistance.⁸ Registry and pooled data suggest robotic-assisted partial knee replacement may have lower revision rates than many conventional partial-knee techniques, though this isn't proven to be due to the robot alone and partly reflects the implant and the surgeon.⁶,⁷
Risks and trade-offs
Robotic assistance doesn't remove the risks that come with any knee replacement, among them infection, blood clots, stiffness, and the small chance of further surgery. A few trade-offs are specific to the robotic approach. The operation takes a little longer, around 15 to 20 minutes more, and planning requires a CT scan, which involves a small amount of additional radiation. The robot supports the surgeon's judgement rather than replacing it. Whether robotic-assisted surgery suits your knee is discussed in detail at your consultation, and as with all joint replacement, individual results vary.
Common questions
Is robotic knee replacement more accurate?
Precision is the best-proven benefit. In knee replacement, pooled randomised trials found robotic assistance reduced the chance of an implant falling outside the target alignment by about two-thirds compared with manual technique. What it has not been shown to do is make a knee replacement last longer or need fewer revisions than well-performed conventional surgery. Precision is the proven benefit, not a guarantee of a better long-term result, and individual results vary.
What does functional alignment change?
In the knee, the Mako system delivers a functional alignment plan, positioning the implant to suit your knee's own shape and ligament balance rather than fitting every knee to one textbook target. Robotic planning makes the approach repeatable, and recent randomised trials report fewer soft-tissue releases. Whether it makes a knee replacement last longer is not yet known.
Does robotic knee replacement cost more for the patient?
No. Using the robotic-assisted system does not add to the cost of your surgery. Robotic planning is part of how Dr Tsung performs knee replacement, not a paid extra. Your out-of-pocket cost depends on the procedure and your health fund, and we go through it with you on the fees and health funds page.
Does robotic assistance make knee surgery take longer?
A little. Robotic-assisted knee replacement takes around 15 to 20 minutes more than conventional surgery, and planning requires a CT scan a week or two beforehand, which involves a small amount of additional radiation. The robotic step does not remove the risks that come with any joint replacement, such as infection, blood clots and stiffness, and individual results vary.
Book or refer
To see Dr Tsung you’ll need a referral from your GP or another specialist. Call reception on (07) 5676 9930 to book your first appointment, or email hello@sgco.au. New patients can pre-register online before the visit; the form prepares your records and does not book an appointment. For costs, see fees and health funds.
References
- Ruangsomboon P, et al. Robotic-assisted versus conventional total knee arthroplasty: a meta-analysis of randomised controlled trials. Annals of Medicine and Surgery. 2025.
- Hannon CP, et al. Does robotic assistance influence recovery after total knee arthroplasty? Bone & Joint Journal. 2025;107-B(10):1054–1063.
- Batailler C, et al. MAKO CT-based robotic arm-assisted system is a reliable procedure for total knee arthroplasty: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy. 2021;29:3585–3598.
- Sodhi K, et al. Robotic-assisted total knee arthroplasty with MAKO is associated with improved functional outcomes: a systematic review and meta-analysis. Bone & Joint Open. 2025;6(11):1382–1393.
- Clement ND, et al. Robotic arm-assisted versus manual total knee arthroplasty (ROAM): a randomised controlled trial. Bone & Joint Journal. 2024;106-B(5):450–459.
- Chen J, et al. Survivorship in robotic total knee arthroplasty compared with conventional total knee arthroplasty: a systematic review and meta-analysis. Arthroplasty. 2025;7:21.
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty: 2025 Annual Report. Adelaide: AOA; 2025.
- Sun C, et al. Comparison of MAKO robotic-assisted and manual unicompartmental knee arthroplasty: a meta-analysis of radiographic precision and short-term functional results. Journal of Robotic Surgery. 2026;20:307.