Asia-Pacific expert consensus on robotic-assisted hip and knee arthroplasty

BACKGROUND: Robotic-assisted total joint arthroplasty (rTJA) has witnessed rapid adoption across the Asia-Pacific region. However, practice heterogeneity and conflicting evidence regarding its clinical value necessitate standardized guidance. Therefore, this expert consensus aims to establish consensus-based recommendations to guide and standardize the clinical application of rTJA. METHODS: The Arthroplasty Society in Asia (ASIA) convened a panel of 45 experts. A modified Delphi technique was employed across three rounds. A systematic literature review informed the generation of consensus statements, which were finalized through anonymous voting. Consensus was defined as ≥ 75% agreement. RESULTS: The panel reached consensus on 18 critical clinical questions spanning general principles, total hip arthroplasty, and total knee arthroplasty. Key consensus points include: (1) rTJA demonstrates superior accuracy in implant positioning and alignment restoration compared to manual techniques (98%); (2) current evidence does not yet support a definitive superiority in long-term survivorship or PROMs (77%); (3) robotic platforms are enabling technologies that make personalized alignment philosophies technically reproducible (100%); and (4) soft-tissue balancing should take precedence over rigid mechanical alignment targets in rTKA when conflicts arise(91%). CONCLUSION: This consensus statement provides a comprehensive framework for the application of robotic technology in hip and knee arthroplasty, emphasizing safety, precision, and the need for rigorous training.

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Publication Details

Journal
Arthroplasty
Published
2026-08-13
DOI
https://doi.org/10.1186/s42836-026-00427-1
Primary Topic
Total Knee Arthroplasty Outcomes
Type
article
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article

Asia-Pacific expert consensus on robotic-assisted hip and knee arthroplasty

Hong Cai, Chandeep Singh, Sébastien Lustıg, PK Chan et al.
Arthroplasty
Total Knee Arthroplasty Outcomes
article

Asia-Pacific expert consensus on robotic-assisted hip and knee arthroplasty

Hong Cai, Chandeep Singh, Sébastien Lustıg, PK Chan, Myung Chul Yoo, Tomoyuki Matsumoto, Lincoln Ming Han Liow, 陈云苏, Sang Eun Park, Eryou Feng, Hongyi Shao, Dirk van Bavel, Takafumi Hiranaka, Haobo Wu, Aree Tanavalee, Zongke Zhou, Seung Jae Lim, Jie Xie, Wenwei Qian, Yukihide Minoda, Seng-Jin Yeo, Xinzhan Mao, Kang-il Kim, Chun Hoi YAN, Andrew Kurmis, - Nicolaas C. Budhiparama, Henry Fu, Michael Ong, Yixin Zhou, David Liu, Yan Wang, Li Cao, Xianzhe Liu, Nobuhiko Sugano, Ming Ni, Xinyu Fang, Andrew Tang, Hao Tang, Wei Chai, Guoqiang Zhang, Xiaogang Zhang, Huiwu Li
article en

Abstract

BACKGROUND: Robotic-assisted total joint arthroplasty (rTJA) has witnessed rapid adoption across the Asia-Pacific region. However, practice heterogeneity and conflicting evidence regarding its clinical value necessitate standardized guidance. Therefore, this expert consensus aims to establish consensus-based recommendations to guide and standardize the clinical application of rTJA. METHODS: The Arthroplasty Society in Asia (ASIA) convened a panel of 45 experts. A modified Delphi technique was employed across three rounds. A systematic literature review informed the generation of consensus statements, which were finalized through anonymous voting. Consensus was defined as ≥ 75% agreement. RESULTS: The panel reached consensus on 18 critical clinical questions spanning general principles, total hip arthroplasty, and total knee arthroplasty. Key consensus points include: (1) rTJA demonstrates superior accuracy in implant positioning and alignment restoration compared to manual techniques (98%); (2) current evidence does not yet support a definitive superiority in long-term survivorship or PROMs (77%); (3) robotic platforms are enabling technologies that make personalized alignment philosophies technically reproducible (100%); and (4) soft-tissue balancing should take precedence over rigid mechanical alignment targets in rTKA when conflicts arise(91%). CONCLUSION: This consensus statement provides a comprehensive framework for the application of robotic technology in hip and knee arthroplasty, emphasizing safety, precision, and the need for rigorous training.

ArthroplastyVol. 8(1)
Fujian Medical University (CN), Central South University (CN), Xinjiang Medical University (CN), Flinders University (AU), Chinese University of Hong Kong (HK), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Peking University (CN), Universitas Airlangga (ID), Kyoto University (JP), Singapore General Hospital (SG), Sichuan University (CN), Epworth Hospital (AU), Leiden University Medical Center (NL), Peking Union Medical College Hospital (CN), Lyell McEwin Hospital (AU), Samsung Medical Center (KR), King Chulalongkorn Memorial Hospital (TH), First Affiliated Hospital of Xinjiang Medical University (CN), Chinese PLA General Hospital (CN), Beijing Jishuitan Hospital (CN), Max Healthcare (IN), Kyung Hee University (KR), St Vincent's Hospital Melbourne (AU), Hôpital de la Croix-Rousse (FR), West China Hospital of Sichuan University (CN), Shanghai Ninth People's Hospital (CN), Hospices Civils de Lyon (FR), St. Peter's Hospital (CA), Australian Institute for Musculoskeletal Science (AU), First Affiliated Hospital of Fujian Medical University (CN), Wuhan Union Hospital (CN), Peking University Third Hospital (CN), Shanghai Sixth People's Hospital (CN), Kyoto University Hospital (JP), Kyung Hee University Hospital at Gangdong (KR), Second Xiangya Hospital of Central South University (CN), Orthopaedic Research Foundation (US), Second Affiliated Hospital of Zhejiang University (CN), Union Hospital (CN), Takatsuki General Hospital (JP), First Affiliated Hospital Zhejiang University (CN), Osaka Metropolitan University (JP), Huazhong University of Science and Technology (CN), The University of Adelaide (AU), Tokyo Metropolitan University (JP), Sungkyunkwan University (KR), University of Hong Kong (HK), The University of Osaka (JP)
Openalex Percentile: Top 7%
Total Knee Arthroplasty Outcomes
DOIOpen Access PDFOpenAlex
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