The Path to Full Robotic Integration in Orthopaedic Surgery: A Binational Perspective

Robotic-assisted technology is transforming total joint arthroplasty (TJA), though surgeons often take very different paths to adoption. This binational perspective compares two high-volume practices. One, in the United States, has relied exclusively on a single robotic platform (Mako®) for more than 7,000 procedures, refining workflows to support same-day discharge and consistent outcomes. The other, in Italy, adopted a multi-platform strategy, achieving proficiency with ROSA®, CORI™, and Mako® systems and transitioning to 100% robotic utilisation within a year. Despite contrasting approaches, both models have delivered measurable gains in surgical accuracy, reproducibility, soft tissue preservation, and recovery speed compared with manual techniques. The robotic “learning curve” is reframed as a continuous process of technical and cognitive refinement. When supported by deliberate use, institutional commitment, and adaptability, diverse strategies can achieve full robotic integration and improve patient-specific care.