At the forefront of next-generation spine care is robotic-assisted surgery—a minimally invasive approach that combines robotic technology, advanced navigation systems, and real-time imaging...

Scientists from Nanyang Technological University, Singapore (NTU Singapore) have developed a tiny seed-sized robot that can navigate across soft and uneven surfaces to perform five surgical functions wirelessly, paving the way for developing robots to make surgeries and medical treatments more...

Learning Point of the Article : This article emphasizes that robotic-assisted knee arthroplasty enhances surgical precision and implant alignment, optimal outcomes primarily depend on structured rehabilitation. Prehabilitation helps patients prepare physically and mentally for surgery, while early post-operative physiotherapy promotes faster recovery and improved mobility. Phased rehabilitation with strengthening exercises, range of motion exercises and gait training, combined with modern approaches like ERAS protocols and multimodal pain management are essential for optimal functional recovery after knee replacement. Editorial | Volume 16 | Issue 04 | JOCR April 2026 | Page 1-3 | Sagar Deshpande [1], Sachin Kale [2,3,4], Dnyanesh Patil [5], Ashok Shyam [6,7] . DOI: https://doi.org/10.13107/jocr.2026.v16.i04.7014 Authors: Sagar Deshpande [1], Sachin Kale [2,3,4], Dnyanesh Patil [5], Ashok Shyam [6,7] [1] School of Physiotherapy, DY Patil deemed to be University, Navi Mumbai, Maharashtra, India; [2] Department of Orthopedics, D Y Patil Hospital and Medical College, Navi Mumbai, Maharashtra, India, [3] Department of Orthopedics, Apollo Hospital, Navi Mumbai, Maharashtra, India, [4] Department of Orthopedics, Fortis Hospital, Navi Mumbai, Maharashtra, India, [5] School of Physiotherapy, DY Patil deemed to be University, Navi Mumbai, Maharashtra, India; [6]I ndian Orthopaedic Research Group, Thane, Maharashtra, India, [7] Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India. Address of Correspondence: Dr. Sachin Kale, Department of Orthopaedics, Dr D Y Patil School of Medicine, Navi Mumbai, Maharashtra, India. Email: sachin.kale@dypatil.edu Article Received : 2026-01-08, Article Accepted : 2026-03-05 Introduction: Robotic-assisted knee arthroplasty (RAKA) has transformed knee reconstruction by optimizing soft-tissue balance, improving implant alignment, and surgical precision. Even though technological advancements have enhanced surgical accuracy, comprehensive rehabilitation remains the key determinant of functional success. Optimal long-term patient-reported outcomes are achieved when surgical accuracy is supported by structured rehabilitation [1,2]. The Imperative of Pre-operative Rehabilitation (“Prehabilitation”)Pre-operative rehabilitation, often known as prehabilitation, is a systematic approach that helps patients get ready for surgery both mentally and physically. It includes patient education, lifestyle changes, risk-factor optimization, and focused exercise regimens. Enhancing muscle strength, joint mobility, cardiovascular endurance, and psychological preparedness is the main goal of prehabilitation to provide the ideal physiological environment for surgery and accelerate post-operative recovery [1,2]. Growing research supports the usefulness of prehabilitation in enhancing post-operative outcomes following total knee arthroplasty. An umbrella review of pre-operative rehabilitation suggests that exercises may facilitate early functional recovery and reduce post-operative functional disability, but functional improvements are inconsistent due to varied rehabilitation protocols [2]. According to systematic reviews and meta-analyses, structured exercise-based prehabilitation programs are linked to better early functional outcomes and less post-operative pain [3,4]. Individual-tailored prehabilitation programs are most helpful when they are adapted to comorbid conditions, pain severity, and baseline functional level. Aerobic conditioning, balance and proprioceptive exercises, progressive resistance training for the quadriceps and hamstrings, and patient education on post-operative expectations, use of assistive devices, wound care, and pain management are important components. Importantly, patients who have a limited range of motion, obesity, or lower baseline function seem to gain most from tailored prehabilitation techniques [5]. Post-operative Rehabilitation: Phased and PersonalizedFollowing a RAKA, post-operative rehabilitation is a goal-oriented, phased process that starts right after surgery and lasts until functional independence is attained. Modern rehabilitation practices, which prioritize early mobilization, multimodal analgesia, and progressive functional loading, are closely aligned with the principles of enhanced recovery after surgery (ERAS) [6]. Early quadriceps activation, safe transfers, aided ambulation, and pain and edema management are the main goals of rehabilitation during the early post-operative period. Research indicates that starting physical therapy within the first 12–24 h following surgery improves functional results and shortens hospital stays when compared to delayed mobilization [7,8]. Early ambulation is particularly viable following robotic-assisted operations due to enhanced implant alignment and soft-tissue balance [8,9]. Restoring knee range of motion, strengthening periarticular muscles, enhancing neuromuscular control, and retraining gait patterns become more important as rehabilitation goes on. Robotic precision in implant location has been related with speedier recovery of knee motion, allowing physicians to advance rehabilitation procedures with more confidence while minimizing compensatory movement patterns [9]. During the intermediate and late stages of recovery, balance training, proprioceptive exercises, stair climbing activities, and cardiovascular conditioning become more crucial [5]. Post-operative recovery is greatly improved by new recent rehabilitation methods and protocols. When compared to traditional rehabilitation alone, the utilization of robotic and exoskeleton-assisted rehabilitation systems inside ERAS pathways has shown improvements in knee range of motion, functional outcomes, and shorter hospital duration [6]. Furthermore, tele-rehabilitation systems present viable ways to enhance long-term functional recovery and sustain to home-based exercise regimens. Multimodal Integration: Pain, Function, and TechnologyEffective rehabilitation requires the use of multimodal pain management techniques in addition to exercise recommendations. Modern analgesic regimens that include non-opioid systemic drugs, periarticular infiltration, and regional anesthesia promote early mobilization, lower opioid use, and increase patient involvement in rehabilitation programs [5]. Synchronizing pain management with functional advancement requires close coordination between anesthesiologists, surgeons, and rehabilitation specialists. A paradigm change in knee arthroplasty care is represented by the combination of robotic surgery and evidence-based rehabilitation. Robotic devices improve surgical accuracy, but rehabilitation makes sure that these technological advances result in significant functional outcomes, such as walking endurance, stair-climbing ability, and return to activities of daily activities [9]. Conclusion: Despite advances in the precision of robot-assisted knee arthroplasty, successful outcomes primarily depend on post-operative functional performance. While organized, structured post-operative rehabilitation guarantees long-term functional improvements; pre-operative rehabilitation maximizes physical preparedness and improves post-operative recuperation. For robotic-guided knee arthroplasty to be successful, rehabilitation should be considered a key component rather than an adjunct. Personalized care pathways and new technologies will improve results as rehabilitation science advances. Rehabilitation continues to be the vital link between surgical accuracy and patient-centered recovery in the age of robotic knee replacement. References1. Afzal W, Arif K, Rashid HM, Tariq M, Khalid J, Mohsin A, et al. Effect of pre-operative, post-operative and combined rehabilitation approaches in total knee replacement. Insights J Health Rehabil 2025;3:293-301. [Google Scholar] [PubMed]2. Zhao Y, Tian C, Tian S, Han W, Shi H, Cao M, et al. An umbrella review for preoperative rehabilitation in primary total knee arthroplasty: Quality assessment and summary of evidence. BMC Musculoskelet Disord 2025;26:630. [Google Scholar] [PubMed]3. Karimijashni M, Yoo S, Barnes K, Lessard-Dostie H, Ramsay T, Poitras S. Prehabilitation in patients at risk of poorer outcomes following total knee arthroplasty: A systematic review. J Arthroplasty 2025;40:1367-76. [Google Scholar] [PubMed]4. Zhang W, Lu X, Yang N, Zhu X, Hu H. Prehabilitation is effective in relieving pain after knee arthroplasty, but has little effect on length of stay and knee function: A meta-analysis of randomized controlled trials. Front Med (Lausanne) 2025;12:1457407. [Google Scholar] [PubMed]5. Clark NC. Prehabilitation and rehabilitation for total knee replacement surgery: Physiotherapy interventions in personalized medicine and charting a course towards optimal outcomes. Orthop Trauma 2025;39:65-73. [Google Scholar] [PubMed]6. Wang M, Tang Z, Lan Y, Lan R, Wang M, Song X, et al. Application and postoperative rehabilitation effects of HURWA, Cori, and Brainlab robots in TKA under the ERAS concept. J Robot Surg 2025;19:669. [Google Scholar] [PubMed]7. Thwin L, Chee BR, Yap YM, Tan KG. Total knee arthroplasty: Does ultra-early physical therapy improve functional outcomes and reduce length of stay? A retrospective cohort study. J Orthop Surg Res. 2024;19:288. [Google Scholar] [PubMed]8. Zhou G, Yao Y, Shen Y, You X, Zhang X, Xu Z. Early ambulation after total knee arthroplasty: A retrospective single-center study. J Orthop Surg Res. 2024;19:446. [Google Scholar] [PubMed]9. García-Sanz F, Sosa-Reina MD, Jaén-Crespo G, González-De-La-Flor Á, Villafañe JH, RoSmero-Morales C. Redefining knee arthroplasty: Does robotic assistance improve outcomes beyond alignment? An evidence-based umbrella review. J Clin Med 2025;14:2588. [Google Scholar] [PubMed] Dr. Sagar DeshpandeDr. Sachin KaleDr. Dnyanesh PatilDr. Ashok Shyam How to Cite This Article: Deshpande S, Kale S, Patil D, Shyam A. Redefining Outcomes in Robotic-Guided Knee Arthroplasty through Purposeful Rehabilitation. Journal of Orthopaedic Case Reports 2026 April, 16(04): 1-3.

Distalmotion has submitted a 510(k) application to the FDA seeking clearance to use the DEXTER robotic surgery system for sacrocolpopexy, sacrocervicopexy and endometriosis resection.

In The Week’s “Deskilling: A Dangerous Side Effect of AI Use,” the first line beneath the image reads: “Atrophied skills have been observed across a wide array of fields, including medical and mental health.” As an organizational learning and development strategist for a large behavioral health care provider, I have had this on my radar for quite some time, but I believe it should be on yours as well. Even more, as a longtime L&D professional and computer information systems educator with professional and academic backgrounds spanning adult education, higher education, information technology and organizational learning, I find this outcome unsurprising. Of course, technology has always reshaped work. What is different today is the speed with which large language models have been introduced at scale, often without sufficient preparation, governance or thoughtful integration. Hype cycles have a way of running ahead of practice, and eventually the dust settles. The Week’s article also provided examples from each of the three primary domains in which I work: In mental health, therapists are “allowing themselves to become passive in the act of therapy,” essentially becoming a “supervisor over the AI use for therapy” while limiting their “reflexive diagnostic thinking,” according to Forbes. In technology, computer coding is increasingly being delegated to AI, shifting human developers toward integration, monitoring and higher-level analysis, according to the American Enterprise Institute. In education, many students are using AI to write essays or conduct research. Yet, as The Atlantic notes, “The term paper, for all its tedium, teaches a discipline that’s hard to reproduce in conversation: building an argument step by step, weighing evidence, organizing material, honing a voice.” Over the past three years, I have intentionally observed this unfold. I’ve followed analyses from fellow L&D professionals and from professionals across industries. Some of those conversations have lacked nuance, particularly in sectors like health care, where the context differs significantly from many commercial environments. Too often in these conversations, AI has been presented as inherently good and urgently in need of implementation without sufficient clarity about the problems being solved, the value being created or how people will adopt, integrate and sustain the change over time. For nearly my entire career, I have worked to understand both sides: the human and the technological. I have never chosen a lane. But I have always believed there is an ethical order of prioritization. One of The Week article’s most important observations is that deskilling is not inherently negative. It has occurred throughout history and has contributed to many of the advances we benefit from today. The more important question is not whether deskilling occurs, but, rather, how much is appropriate, in what contexts and with what safeguards. Those questions require systematic and systemic thinking. The article also highlights another concern I have also been raising: What happens when the technology is unavailable? When I recently discussed on LinkedIn the importance of surgeons maintaining the ability to perform procedures without robotic assistance should a system fail mid-operation, another LinkedIn user made a similar point. The same principle explains why pilots continue to practice manual landings even though commercial aviation relies heavily on automation. Automation can extend human capability, but resilience depends on preserving essential human expertise. Then there is the question of equity. At times, conversations on LinkedIn proceed as though everyone, everywhere, has equal access to the same technologies and will experience AI in the same way. They will not. Not every health care system can afford multimillion-dollar surgical robotics platforms. When I underwent surgery in 2013, the robotic system being used at Johns Hopkins Medicine was, at the time, unique within my region. Access to advanced technology varies considerably across health care organizations, communities and countries. We also tend to overlook the ongoing costs of these systems. Sometimes discussions treat AI adoption as though it is inevitable and self-sustaining. Yet these technologies depend upon continual investment in fresh knowledge and research, much of which comes from institutions that some now argue AI is replacing, including higher education and journalism. They also depend upon significant computing infrastructure, energy, water and the people who build, maintain, govern and improve these systems. Because I completed my doctoral work within a school of education and urban studies grounded in a social justice mission, equity will always be one of the lenses I bring to both research and practice. That perspective also shaped my own doctoral research. I examined how systems usability varied across regions, including rural and urban communities where differences in digital infrastructure significantly affected access and user experience. Those same infrastructure differences continue to matter in health care today. I also tried to ensure my professional experiences reflected those realities. In 2012, I accepted a significant pay cut to work in a rural community while completing my doctorate. Later, I returned to a larger suburban region outside Washington, D.C., continuing my work across different organizational settings. Experiencing multiple contexts has been important to developing a broader perspective rather than assuming one environment represents everyone. I mention this because it matters. When people make decisions that affect others, they must understand the people those decisions affect and make reasonable efforts to understand their experiences. Not everyone will have opportunities to work across as many settings as I have, but I have found one principle to be consistently true: When we neglect those whose needs are less visible, the consequences eventually extend far beyond those communities. This is why I continue to advocate for partnership, unhurried practice and thoughtful exploration before deciding what should and should not be delegated to AI. Those decisions should be considered through multiple lenses. Philosophically, we should ask questions about ethics, equity, justice, human agency, professional responsibility and what kinds of expertise we believe society ought to preserve. Practically, we should examine patient safety, workforce capability, organizational resilience, regulatory requirements, cost, infrastructure, accessibility, continuity during system failures and long-term learning. Technology has always changed what people do. The more enduring question is whether we are being equally intentional about preserving what people still need to know.

MediThinQ, a South Korea-based innovator in surgical visualization technologies, has entered into an exclusive multi-year distribution agreement with Synovis ...

A revolutionary leap in maxillofacial reconstructive surgery has been unveiled with the development of an integrated system that combines robot-assisted osteotomy and augmented reality (AR) guidance.This groundbreaking approach, spearheaded by a team of researchers at the Beijing Institute of Technology,...

Discover the top robotic surgery companies and healthcare stocks to watch in 2026, including leaders in AI-assisted surgical systems and minimally invasive technology.

Leading the evolution of robotic surgery through nursing excellence.

Meril introduces A.R.M.O.R.
Advanced Robotic Management for Operating Room Nurses.

A first of its kind initiative designed to support nursing professionals with the knowledge, skills, and confidence required in robotic assisted surgery.

As surgical technology continues to evolve, operating room teams play a critical role in enabling seamless workflows, precision, and consistency in clinical practice.

A.R.M.O.R. reflects Meril’s continued focus on education, capability building, and advancing the future of robotic healthcare.

#Meril #ARMOR #RoboticNursing #RoboticSurgery #HealthcareInnovation #MedTech #SurgicalExcellence #MoreToLife

Surgical robotics has evolved, expanding into a diverse ecosystem of procedure‑specific technologies — each pushing new technical requirements onto the motion systems at their core.