Why this matters
Robotic precision was never supposed to be a boutique feature. When the ROSA® platform became available at The Queen's Medical Center — Hawai‘i's largest hospital — it closed the gap between the two kinds of joint replacement patients: healthy candidates who fly through same-day outpatient surgery, and patients whose medical conditions, complex anatomy, or revision situations call for hospital-level support. Hospital knee patients now get the same 3D planning and sub-millimeter execution; complex revisions are their own case, and a CT scan is often used to plan them.
What ROSA adds in a hospital setting
ROSA builds its surgical plan from standard X-rays — no CT required — and gives the surgeon live feedback on alignment, component position, and soft-tissue balance throughout the operation. For the complex cases that gravitate to Queen's (significant deformity, prior hardware, fragile bone), that intraoperative verification matters even more than in routine joints. Dr. Morton, certified across four robotic platforms, used ROSA for Hawai‘i's first robotic-assisted total hip replacement in 2022, and it is his primary platform for knee replacements at Queen's; his robotic hips are now done on Mako at Hilo Community Surgery Center.
Choosing your venue, keeping the precision
The practical upshot for patients: venue choice no longer trades away technology. Healthy candidates keep the same-day outpatient experience; knee patients directed to Queen's by health, complexity, or insurance keep robotic precision. Where your surgery belongs is decided with you at consultation — what stays constant is how carefully it's planned and executed.
Medically reviewed by Paul Norio Morton, MD, FAAOS, FAAHKS. Last reviewed: . This article is for education only and isn’t a substitute for an exam and personalized advice — schedule a consultation to discuss your situation.