Jun 4 • Dr. Stephen Howell, MD

The Consent Discussion: The Robot Demands

Welcome to the KA Optimized Editorial, a monthly series built around a single premise: contemporary orthopedic evidence deserves a straight read. Each issue takes a study or two, and in six minutes, explains what it means for the patient, the surgeon, or the field.  

This month's editorial starts in the consent room. Two studies landed in the same window earlier this year — RASKAL and a population-level dataset out of Ontario covering 74,359 primary total knee arthroplasties — and together they answer the two questions that matter most before a patient signs anything: Does the robot make them feel better? And does it make them safer? The answers are now in, and they point in the same direction.
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MacDessi SJ, Wernecke GC, Ghadirinejad K, et al. Robotic-assisted surgery and functional alignment in total knee arthroplasty: the RASKAL registry-nested 2 × 2 factorial randomized trial. Bone Joint J. 2026;108-B(5):622-633. doi: 10.1302/0301-620X.108B.BJJ-2025-1472.R2 

Pincus D, Ekhtiari S, Lex JR, Schemitsch E, Ruangsomboon P, Paterson JM, Ravi B, Association Between Adoption of Robotic Total Knee Arthroplasty in Canada and Major Surgical Complications, The Journal of Arthroplasty (2026), doi: https://doi.org/10.1016/j.arth.2026.03.077
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