A Surgeon’s Navigator: Russia Advances Personalized Joint Replacement
A patient in Russia’s Samara region has undergone knee replacement surgery with the help of a robotic system. The technology allowed the surgical team to plan the procedure in advance using a 3D model of the patient’s bones.
Clinics at Samara State Medical University, part of Russia’s Ministry of Health system, have performed the region’s first robotic-assisted knee replacement. The first patient had stage IV knee osteoarthritis and significant joint deformity. At this advanced stage, the joint is severely worn, movement becomes painful, and even the simplest everyday activities can be difficult. Joint replacement can restore joint function and help patients return to a more active life.
The system is designed to help surgeons plan procedures more precisely and prepare the bones for implantation of the artificial joint. It is now undergoing clinical evaluation at SamSMU, and the results will play a major role in determining the technology’s future.
A Personalized Surgical Plan
Preparation began before the operation. After the patient was admitted to the hospital, clinicians performed a CT scan of the leg and used the resulting images to create a 3D model of the bones. In specialized software, the surgeon selected the size and position of the implant components and calculated the level and angle at which the bone needed to be prepared. The surgeon then assessed how well the plan matched the individual patient’s anatomy. If adjustments became necessary during surgery, they could also be entered into the software, allowing the team to see how the changes affected the planned parameters.
“This approach allowed us to assess anatomical changes not only visually but also quantitatively, in millimeters and degrees,” said Dmitry Kudashev, head of the university clinics’ No. 2 trauma and orthopedic department.
A Robotic Navigation System
The robotic system combines a navigation platform with a manipulator equipped with a cutting burr. It helps prepare the femur and tibia according to predefined parameters, shaping the bone surfaces for the implant. But the robot does not replace the surgeon. The physician plans the procedure, sets the system’s operating parameters and supervises its work. Medical staff still perform the surgical approach, manage soft tissues, position the implant and close the incision.
Knee replacement requires careful consideration of each patient’s individual joint anatomy. SamSMU surgeons therefore use an approach intended to restore the joint’s natural alignment, as it was before osteoarthritis developed. “With the robotic system, we were able to position the implant components precisely and achieve the soft-tissue balance needed for joint stability and early, full functional recovery,” Kudashev said.
The accuracy of implant positioning affects how well the artificial joint functions after surgery, as well as how smoothly and successfully the patient progresses through rehabilitation.
Robotic Surgery Expands Across Russian Regions
Clinics in cities across Russia are gradually adopting robotic-assisted joint replacement. In 2024, Moscow’s First City Hospital and the Pirogov National Medical and Surgical Center reported using robotic systems for knee replacement. The Pirogov center had performed more than 30 such procedures.
In March 2025, robotic-assisted joint replacement was evaluated at the University Clinic of Privolzhsky Research Medical University. In July of the same year, the Novorossiysk Clinical Center of Russia’s Federal Medical-Biological Agency reported its first operation using the CORI system.
By fall 2026, other medical institutions had also begun using robotic systems. In September, the University Clinic of Privolzhsky Research Medical University announced that it had started using Stryker’s Mako system for knee and hip replacement.
The range of systems from different manufacturers shows that robotic-assisted joint replacement is becoming a distinct area of clinical equipment investment. This creates opportunities for Russian IT specialists and medical software developers. If SamSMU’s technology proves its value in clinical practice, it could also have a path to international markets.
