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Scoping Review · Patient & Public Perception

Perceptions of robot-assisted arthroplasty among patients and the public

A scoping review conducted in accordance with the PRISMA-ScR framework

Morrison SR, Clement ND, Clarke JV, Gee C, Chopra S, Hall AJ

Bone Jt Open 2026;7(6):733–743 · doi:10.1302/2633-1462.76.BJO-2026-0007.R1
16
Included Studies
3,957
Total Participants
4
Key Themes Identified
6
Countries Represented
As Published Perceptions of robot-assisted arthroplasty among patients and the public, as published in Bone & Joint Open
British Editorial Society of Bone & Joint Surgery

This scoping review was published as a Systematic Review in Bone & Joint Open, a fully open access companion journal to The Bone & Joint Journal. The article is freely available to read and download in full, with open access funding provided by the Golden Jubilee Endowment Fund.

Journal Bone Jt Open
Article Type Systematic Review
Licence CC BY-NC-ND 4.0
Access Open Access
Read on boneandjoint.org.uk Download PDF

Abstract

Aims
The use of robotic-assisted surgery (RAS) in total hip and knee arthroplasty is increasing, offering potential benefits in implant positioning accuracy. However, patient and public perceptions, including concerns and preferences, remain poorly understood. This scoping review aimed to explore the literature on patient and public perceptions of RAS in orthopaedics, identify common themes, assess knowledge gaps, and inform future research priorities.
Methods
A five-stage scoping review was undertaken according to the PRISMA extension for Scoping Reviews. Searches were performed across PubMed, Directory of Open Access Journals, Scopus, and ProQuest Central; Google Scholar and reference lists were also searched. Articles were collated and evaluated against predetermined criteria. Data from included studies were collated to facilitate descriptive and thematic analysis.
Results
A total of 16 studies were included, primarily cross-sectional surveys. Four major themes were identified: interest in RAS; understanding regarding RAS; concerns regarding RAS; and influences on preferences and perception. Patients often overestimated the prevalence of use and the benefits of RAS, and based their preferences on marketing or limited information. Trust in surgeons remained a strong influence on patient attitudes.
Conclusion
Despite growing patient enthusiasm for RAS, significant gaps in public understanding and perception persist. Many patients held inaccurate beliefs about RAS capabilities and benefits. Future research should focus on creating validated educational tools for patients about RAS, expanding studies across diverse populations, and clarifying the value of RAS. Aligning public perception with clinical and non-clinical evidence is essential for informed consent and ethical surgical innovation.
Study Characteristics
Study designScoping review
FrameworkPRISMA-ScR
Included studies16
Total participants3,957
Mean participant age62.5 yrs (SD 6.9)
Lead institutionGolden Jubilee
Publication
JournalBone Jt Open
Volume / Issue7(6)
Pages733–743
PublishedJune 2026
View paper (Open Access)

Search & Selection

PRISMA-ScR screening process

455
Records identified across databases
→
351
Screened after duplicates removed
→
15
Full-text articles assessed
→
16
Studies included (+1 via citation review)

336 records were excluded at screening, most commonly for not being relevant to patient perceptions of RAS (n=181) or lacking objective findings or empirical data (n=55). No articles were excluded at full-text review.

Thematic Analysis

Four key themes

Interest in RASn=6 studies
Interest was consistently high: 77.8% of patients in one study said they would explore RAS if they required arthroplasty, and 75.5% were familiar with robotic surgery terminology in another.
Google search volumes for robotic joint arthroplasty have risen exponentially since 2011, with one analysis projecting search interest to double again by 2030.
A substantial proportion of interested patients had formed views from advertising or media exposure rather than clinician-led education.
Understanding of RASn=13 studies
Despite interest, depth of understanding was often limited: 49.3% of patients rated their own RAS knowledge as poor or very poor in one study, and 71% reported being unfamiliar with it in another.
A widespread misconception was that robots operate autonomously, with up to 70% of patients across several studies believing a robot could perform half or more of a procedure without surgeon input.
Patients commonly overestimated how widely RAS is used, and frequently believed it guaranteed better outcomes, including greater precision, less pain, fewer complications, and faster recovery.
Concerns Regarding RASn=8 studies
Surgeon inexperience with robotic systems was a recurring worry, reported by 28.7% of patients in one survey, with similar concerns echoed in qualitative interview data.
Robot malfunction was a significant concern across multiple studies, with as many as 88% of patients in one survey expressing worry about this possibility.
Radiation exposure from preoperative CT scanning was also raised, with 34.8% of patients in one study saying they would prefer to avoid a CT if an alternative were available.
Influences on Perceptionn=4 studies
Younger, more educated, digitally literate, and more affluent patients, along with those from urban populations, were consistently more receptive to RAS.
Trust in the operating surgeon outweighed trust in the technology itself: 98% of patients in one study wanted their surgeon taking an active intraoperative role regardless of robotic assistance.
Notably, 48.8% of patients in one survey said they would prefer a low-volume surgeon using robotic technology over a high-volume surgeon using conventional technique.

Descriptive Analysis

Who was studied, and how

12 / 16
Cross-sectional observational studies
62.5 yrs
Mean participant age (SD 6.9)
2,204
Of 3,957 participants were female
56.25%
Of studies originated from the USA
2024
Majority of studies published this year

Study Summary Infographic

Infographic summarising public perception of robotic orthopaedic surgery: interest, understanding, concerns, influences, and research priorities

Research Priorities

Knowledge gaps and limitations

01
Most evidence comes from non-validated, cross-sectional surveys
A larger study using a validated questionnaire across diverse populations and health systems would yield more reliable, comparable results, and clarify whether optimistic perceptions reflect broader trends.
02
Geographical representation is narrow
Most included studies originated from North America, particularly the USA and Canada, with relatively few from the UK or other healthcare systems, raising questions about generalisability to international populations with different funding structures.
03
Long-term, patient-reported outcome comparisons are lacking
Long-term patient-reported outcomes comparing RAS and manual procedures would better inform the public of the genuine benefits of orthopaedic RAS, and allow evidence-based decision-making.
04
Socioeconomic and cultural influences remain under-explored
Further research into how socioeconomic and cultural factors shape perception and acceptance of RAS would support an optimised approach to shared decision-making and patient information provision.

Take-Home Messages

Patient interest in robot-assisted arthroplasty is high, but misconceptions about robot autonomy and significantly improved outcomes are common, highlighting a gap between perception and evidence.
Closing this gap is critical for safe, informed, and patient-centred innovation.