Robotic Surgical Systems in Orthopaedics: Clinical Efficacy, Economic Evaluation, and Implementation Challenges

Abstract

Orthopaedic surgery is rapidly undergoing a technological transformation, driven by the integration of digital navigation, computer-assisted planning, and robotic systems. Robotic surgical systems are primarily used in knee and hip arthroplasty, as well as spinal surgery, with the goals of improving implant placement accuracy, reducing complication rates, and enhancing patient safety. These technologies have an impact on operation duration, error rates, and learning curves depending on the surgeon’s level of experience. However, high capital investment, maintenance costs, and consumables mean that cost-effectiveness is closely linked to case volume. Thus, the economic sustainability of robotic systems depends not only on technological efficiency but also on high procedure volume, appropriate reimbursement policies, and interdisciplinary operational integration. From an ethical and legal perspective, the spread of robotic surgery has brought new issues to the fore, such as responsibility sharing, transparency of AI-assisted decision systems, data security, and informed consent processes. In terms of clinical management, safe and effective implementation of robotic surgery requires standardized training programs for surgeons and teams, ongoing technical support, and clear, understandable policies and regulations. This review examines orthopaedic robotic surgery in terms of clinical efficacy, economic evaluation, and management, aiming to propose a holistic approach for the safe, ethical, and financially sustainable integration of technology into healthcare systems.