Patient interests and perspectives regarding robotic-assisted total joint arthroplasty in India: A cross-sectional study.

BACKGROUND: Robotic-assisted total joint arthroplasty (rTJA) is increasingly adopted worldwide for its precision and reproducibility. In India, where technology uptake is steadily and rapidly growing but cost-sensitive, patient perceptions of rTJA remain crucial to understand. OBJECTIVE: This cross-sectional observational study aims to assess the level of interest, awareness, and perceived advantages and limitations of rTJA among Indian patients, specifically those diagnosed with osteoarthritis (OA) of the knee and osteonecrosis of the femoral head (ONFH) of the hip. METHODS: A cross-sectional survey was conducted between January and June 2025 among 500 patients with end-stage knee OA or ONFH attending a tertiary private orthopedic hospital in India. A structured, expert-reviewed and pilot-tested questionnaire assessed demographics, awareness, interest, and perceived benefits or limitations of rTJA. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression to identify factors independently associated with patient interest. p < 0.05 was considered significant. RESULTS: Among 500 respondents (mean age 54.3 years; 57% male), 72% expressed interest in rTJA. Interest was comparable across gender (71.1% males vs. 72.8% females; p = 0.707), age groups (< 50 years 74.2%, 50–65 years 71.2%, > 65 years 69.3%; p = 0.241), education levels (range 67.2–76.8%; p = 0.070), and insurance status (insured 71.9% vs. uninsured 71.8%; p = 0.499). Most participants perceived improved accuracy (75.6%) and reduced complications (79.8%) as key benefits, while high cost (85.4%) and surgeon learning curve (62.8%) remained major concerns. CONCLUSION: Indian patients show growing acceptance of rTJA, but financial constraints and misconceptions remain barriers. Greater patient education, insurance support, and surgeon training are key to wider adoption.