5 Reasons to Have CT‑based Robots in Your OR
In the dynamic field of orthopedic surgery, precision and efficiency are crucial for enhancing patient outcomes and optimizing operational workflows within the operating room. One impactful technological innovation in recent years has been the integration of CT‑based robotic systems. These systems have revolutionized the way orthopedic surgeons perform complex procedures, particularly in joint reconstruction and spine surgery. Unlike traditional navigation systems or fluoroscopy-based robots, CT‑based robotic systems utilize high-resolution three-dimensional imaging for preoperative planning and real-time intraoperative guidance. This allows surgeons to tailor each procedure to the patient’s unique anatomical profile with a high degree of accuracy.1 As the demand for more accurate, reproducible, and patient-specific outcomes grows, the adoption of CT‑based robotics is rapidly becoming a critical component in contemporary orthopedic arthroplasty practices.2 The following are five reasons why orthopedic surgeons should consider integrating CT‑based robotic systems into their knee arthroplasty practice.
1. Access Better Imaging During Surgery
One of the most impactful benefits of CT‑based robotic systems in knee replacement surgery is the ability to access advanced imaging intraoperatively. Preoperative CT scans offer highly detailed, three-dimensional anatomical representations that surpass the resolution and accuracy of traditional fluoroscopy or X-rays. This data is used to create a personalized surgical plan before any incision is made, ensuring that patient-specific variations in anatomy are taken into consideration.
During surgery, these systems offer real-time image guidance based on the preoperative CT‑based plan, allowing for dynamic updates and cross-referencing of anatomical landmarks. This is especially useful in complex procedures like total knee arthroplasty, where anatomical precision is crucial for implant alignment and longevity.3
Studies have shown that CT‑based systems like the TMINI® Miniature Robotic System improve visualization and reduce the rate of intraoperative complications, particularly in patients with abnormal anatomy or prior surgical hardware. Surgeons may also gain a heightened level of confidence knowing that their preoperative plan can be followed with precision and consistency throughout the case.1 Enhanced visualization also aids in the teaching and training environment, allowing surgical residents and fellows to potentially better understand intraoperative anatomy and decision-making.
2. Improve Accuracy and Precision
The TMINI® Miniature Robotic System, guided by CT imaging, offers support to the surgeon’s expertise in bone preparation and implant placement. The state-of-the-art miniature, handheld, wireless robotic system enables accurate and precise implant placement, yielding cuts and implant placements that can be made according to the plan with sub-millimeter accuracy and precision.1
In joint arthroplasty, for example, malalignment of implants can lead to early wear, joint instability, and the need for revision.4 CT‑based robots help mitigate these risks by executing the surgical plan accurately to the preoperative plan.1 A meta-analysis of robotic-assisted total knee replacements reported significantly improved mechanical axis alignment compared to manual techniques, which translates to better Knee Society Scores in early post-operative follow-up and shorter hospital stays.5
Additionally, robotic systems reduce intraoperative variability, which enhances reproducibility across cases and among different surgeons, potentially offering a higher standard of care.6 This is especially important in high-volume centers aiming to deliver consistent, data-driven outcomes. Precision in implant alignment is also crucial for the long-term survivorship of the prosthesis, further supporting the case for robotic implementation.7
3. Save Time During Procedures
Although early iterations of robotic surgery were criticized for increasing operative time, CT‑based robotic systems have matured significantly and now may offer time-saving advantages, especially for experienced surgical teams.8 Once the preoperative plan is loaded, robotic systems may allow for more streamlined bone resections, faster instrumentation alignment, and reduced intraoperative decision‑making.8
Time efficiency is particularly evident in cases with complex anatomies, where traditional freehand techniques could require lengthy adjustments or intraoperative imaging.
During the early utilization of robotic-assisted knee arthroplasty, it is common for operative times to be longer than previously obtained from traditional arthroplasty procedures. However, as the learning curve is overcome, orthopedic surgeons are able to complete the knee replacement with similar operative times and with improved accuracy.9 This was demonstrated in a cohort of seven orthopedic surgeons who were able to improve their operative times within 10 cases, including those introducing a new implant system to their practice.10
With the system’s integration into surgical workflows, ancillary staff can also benefit from more predictable case durations, potentially increasing daily case volumes without sacrificing quality.
4. Make Surgery Safer for Patients
Improved safety is among the most compelling reasons to integrate CT‑based robotic systems into orthopedic practice. By increasing surgical accuracy and reducing variability, these systems contribute to better early patient outcomes, shorter hospital stays, and higher rates of discharge home without increasing the rate of complications.11
The use of CT‑based robotic systems can help surgeons accurately place implants. The use of robotics in knee arthroplasty has been associated with lower ESR and CRP levels during the immediate postoperative period, suggesting decreased inflammation related to the operative procedure.12 Furthermore, this correlated with improved passive and active range of motion in the studied patients.12
In high-risk populations – such as those with obesity, bone deformities, or comorbidities – the benefits of robotic assistance become even more evident.13 With improved component positioning, the use of robotic-assisted knee arthroplasty may help to achieve better alignment in higher-risk patients, especially in the obese population.
Overall, studies have suggested improved early functional recovery, shorter hospital stays, and a greater proportion of patients being discharged home.5,11 While long-term studies show similar outcomes between robotic-assisted and traditional knee arthroplasties, the effects on longevity will be an interesting aspect as longer follow-up data is obtained.
5. Reduce Physical Strain on Surgeons
Orthopedic procedures are physically demanding, requiring repetitive movements, prolonged static postures, and high levels of precision, all of which can contribute to musculoskeletal fatigue and long-term occupational injury among surgeons.14
Research indicates that poor ergonomic practices and physiological stress can significantly hinder surgical performance and lead to injuries.15 Notably, arthroplasty surgeons experience a disproportionately high prevalence of musculoskeletal pain, highlighting the need for improved ergonomic strategies in the operating room.16
Robotic-assisted total knee arthroplasty has been shown to reduce physiologic stress, lower energy expenditure per minute, and decrease postural strain for surgeons when compared to conventional total knee arthroplasty.17 The use of robotic assistance has the potential to enhance surgical efficiency and lessen the workload for physicians. However, additional studies are required to evaluate whether these improvements translate into a reduction in musculoskeletal pain and injuries among surgeons.17
Final Thoughts
CT‑based robotic systems are transforming orthopedic surgery by providing advantages in various aspects of surgical procedures. These systems may contribute to improved safety, efficiency, and overall surgeon well-being. Although there are initial costs and training required, the long-term benefits, such as enhanced patient outcomes, increased procedural efficiency, and better health for surgeons, make a strong case for their adoption in orthopedic operating rooms.
With growing evidence supporting the integration of robotic systems, contact our experienced professionals to see how the TMINI® Miniature Robotic System fits in your OR. It is an opportune moment for proactive orthopedic surgeons to assess the clinical, operational, and ergonomic benefits that CT‑based robotics can offer in their surgical practices and see how TMINI® gives you more room to operate.
1 Data on file. Data is based on TMINI System assisted placement of cut guide compared to planned placement.
2 American Joint Replacement Registry (AJRR): 2024 Annual Report. Rosemont, IL: American Academy of Orthopaedic Surgeons (AAOS), 2024
3 Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994;(299):153–156.
4 Berend M. Consequences of Malalignment in Total Knee Arthroplasty: Few if Any-Opposes. Seminars in Arthroplasty JSES. 2010;21(2):99–101.
5 Zhang J, Ndou WS, Ng N, et al. Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis. Knee
Surg Sports Traumatol Arthrosc. 2022;30(8):2677-2695.
6 Walgrave S, Oussedik S. Comparative assessment of current robotic-assisted systems in primary total knee arthroplasty. Bone Jt Open. 2023;4(1):13-18.
7 Lakstein D, Zarrabian M, Kosashvili Y, Safir O, Gross AE, Backstein D. Revision total knee arthroplasty for component malrotation is highly beneficial: a case control study. J Arthroplasty.
2010;25(7):1047-1052.
8 Data on File, TS-24-058 RevA TMINI Limited Market Release Observational Study. Study included 7 surgeons who completed at least 15 procedures with the TMINI System. Set up time is an
average over 25 cases and data excludes TMINI System warm up time.
9 Sodhi N, Khlopas A, Piuzzi NS, et al. The Learning Curve Associated with Robotic Total Knee Arthroplasty. J Knee Surg. 2018;31(1):17-21.
10 Data on File, TS-24-058 RevA TMINI Limited Market Release Observational Study. Study included 7 surgeons who completed at least 15 procedures with the TMINI System. Set up time is an
average over 25 cases and data excludes TMINI System warm up time.
11 Khan ST, Emara AK, Zhou G, et al. Robotic-assisted total knee arthroplasty in the USA: Nationwide adoption trends towards 70% by 2030. J Clin Orthop Trauma. 2025;68:103069. Published 2025
May 21.
12 Yuan M, Ling T, Su Q, Wan X, Lai Y, Zhou Z. Safety and Effectiveness of Robotic-Arm Assisted Total Knee Arthroplasty. Orthop Surg. 2024;16(4):882-893.
13 Richardson MK, DiGiovanni RM, McCrae BK Jr, et al. Robotic-Assisted Total Knee Arthroplasty in Obese Patients. Arthroplast Today. 2024;26:101320. Published 2024 Feb 20.
14 Canoles HG, Vigdorchik JM. Occupational Hazards to the Joint Replacement Surgeon: How Can Technology Help Prevent Injury?. J Arthroplasty. 2022;37(8):1478-1481.
15 Alaqeel M, Tanzer M. Improving ergonomics in the operating room for orthopaedic surgeons in order to reduce work-related musculoskeletal injuries. Ann Med Surg (Lond). 2020;56:133-138.
Published 2020 Jun 23.
16 McQuivey KS, Christopher ZK, Deckey DG, Mi L, Bingham JS, Spangehl MJ. Surgical Ergonomics and Musculoskeletal Pain in Arthroplasty Surgeons. J Arthroplasty. 2021;36(11):3781-3787.e7.
17 Haffar A, Krueger CA, Goh GS, Lonner JH. Total Knee Arthroplasty With Robotic Surgical Assistance Results in Less Physician Stress and Strain Than Conventional Methods. J Arthroplasty.
2022;37(6S):S193-S200.
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