Introduction: Osteoarthritis is a common disease that leads patients to seek Total Joint Replacement (TJR). Component misalignments leads to failure of TJR. Computer navigation enhances the precision of component alignment, but the addition of robotic guidance, can boost TJR to a higher level of accuracy.

Methodology: This literature reviewed 29 English language peer reviewed articles from 2002 – 2013 and one website. A conceptual framework was adapted to explain benefits and barriers of adoption of robotic TJR.

Results: A total of ten studies were reviewed with focus on more precise alignment, outcomes, length of stay, and costs. Cost to obtain robotic surgical equipment was found to be about $1 million with maintenance costs approaching $350,000. Discussion: Robotic techniques compared to conventional orthopedic surgery showed slight variances, in favor of robotic procedures. While hospitals have the potential to reduce costs and improve outcomes with robotic TJR, but the expenditure and maintenance have not been proven a clear ROI.

Conclusion: As surgical robotic technology evolves in accuracy and accessibility, joint replacement surgery may benefit from improved precision and decreased healthcare costs. But, costs of equipment purchase, upkeep and surgeon training may impact its full potential in orthopedic surgery in the United States.