Trends in adoption of robotics in arthroplasty: an analysis of the Indian landscape.

Robotic-assisted technology in total joint arthroplasty (TJA) offers improved precision in component placement and alignment, addressing challenges, such as ligament imbalance, malalignment, and patient dissatisfaction. In India, where diverse healthcare settings exist, trends in robotic adoption remain underexplored. This study examines the adoption patterns and geographic distribution of robotic systems for TJA in India, highlighting market dynamics over the past 5 years. A cross-sectional observational study was conducted using data from manufacturers of robotic arthroplasty systems. Annual installations, tier-wise city classifications, and geographic distributions were analyzed. Statistical methods included descriptive analysis for installation trends, time-series visualization for adoption trajectories, and linear regression to forecast 2025 installations. As of September 2024, 290 robotic systems were installed across India. Among these, the CUVIS system (Meril) accounted for 89 installations (30.7%), followed by CORI (Smith and Nephew) with 66 installations (22.8%), and VELYS (DePuy) with 52 installations (17.9%). The MAKO system (Stryker) contributed 38 installations (13.1%), while MISSO (Meril) and ROSA (Zimmer) had 25 (8.6%) and 20 (6.9%) installations, respectively. Tier I hospitals dominated with 50% of installations, while Tier III and IV facilities accounted for only 10%. Linear regression predicts steady growth, with over 80 new robotic installations in 2025. Robotic technology adoption in Indian TJA has surged, with a strong preference for systems offering precision and versatility. However, barriers such as high costs and limited training impede penetration in lower tier facilities. Addressing these challenges could enhance equitable access and support the integration of robotics into diverse healthcare settings.