The role of robotics in trauma and orthopaedics

Whilst robotics have been used in surgery since their first application in neurosurgical biopsies in 1985, many surgeons have limited familiarity or experience with robotics through access or exposure to current or developing applications, particularly the systems that have brought robotics to orthopaedics. This paper reviews the well-established applications of operative orthopaedic robotics, developing and future applications, and extraoperative surgical robotics, with due consideration to their limitations. This review describes the different types of fundamental robotic systems, including master–slave, passive, semi-active and active systems. Its discussion of system types gives the reader insight into the different relationships between surgeon and robot, varying from full active systems, autonomous image-based surgical operating, through to the master–slave direct relationship with the surgeon, with the robot's replication of the surgeon's live tracked movements. A review of widely adopted systems within arthroplasty and developing concepts allows the reader to develop their understanding of how these systems operate and their future potential, giving a broad understanding of robotics. This narrative review discusses the fundamentals of orthopaedic robotics, as systematic reviews of each application, their data sets and evidence have been documented elsewhere. The paper concludes by highlighting the advantages of robotic systems in orthopaedic surgery, such as precision and reproducibility, and insight into the future of orthopaedic robotics and provides a useful basis for understanding the role of robotics in orthopaedics and their potential applications for surgeons.