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