Here we go again. Robots still don’t beat a good manual joint replacement. The UK just put a number on it.
For the Big Orthos, the implication is uncomfortable. Robotic platforms have been the growth engine and the switching-cost story for Stryker, Zimmer Biomet, Smith+Nephew, and the rest.
If NICE and US payers treat these BMJ data and RACER-Knee as the reference standard, the next contract conversation is not “precision.” It is “show me the revision delta or the PRO delta that pays for the tower.”
Hospitals that bought robots for marketing and recruitment are not going to scrap them. They are going to ask why every primary still needs the robot when the registry says the implant survives the same either way.
Evidence from Real-World Evidence: The BMJ Target-Trial Emulations
"660,000+ joint replacements show 5-year survival is essentially identical—precision on paper doesn't translate to fewer early revisions."
Two target-trial emulations in The BMJ, using National Joint Registry data from England, Wales, Northern Ireland, and the Crown Dependencies, cover 666,283 total hips and 697,145 knees done between 2018 and 2024. Robotic cases were the minority: 10,203 hips and 22,11...
