JSES - 2026-08-21 - Journal Article
Public Perceptions of Robotic-Assisted Shoulder Arthroplasty in the United States.
Zabiba A, Menendez ME
Topics
Key Takeaway
58% of U.S. adults preferred robotic-assisted shoulder arthroplasty over conventional surgery, but 62% would choose a high-volume non-robotic surgeon over a low-volume robotic surgeon, with perceived outcome improvement being the strongest predictor of robotic preference (OR 3.31).
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Summary
This cross-sectional crowdsourced survey assessed U.S. public perceptions of robotic-assisted shoulder arthroplasty across 615 adults using the Prolific platform. Most respondents held favorable views—74% believed robotics improves implant positioning accuracy and 67% believed it improves outcomes—yet surgeon volume outweighed technology preference when the two were placed in direct competition. Perceived outcome improvement was the strongest independent predictor of robotic preference (OR 3.31, 95% CI 1.98–5.51), followed by belief in guaranteed results (OR 2.32) and early technology adoption tendency (OR 1.92).
Key Limitation
The Prolific crowdsourcing sample is not representative of patients who actually undergo shoulder arthroplasty—older, lower-income, and less tech-engaged populations are systematically underrepresented, making it impossible to directly apply these preference data to clinical shared decision-making.
Original Abstract
BACKGROUND
Interest in robotic-assisted shoulder arthroplasty is growing, yet public perceptions of this technology remain poorly characterized. This study used online crowdsourcing to evaluate public perceptions and beliefs regarding robotic-assisted shoulder arthroplasty.
METHODS
A cross-sectional survey was completed by 615 adults residing in the United States through the Prolific crowdsourcing platform. The survey assessed demographic characteristics, perceptions of the impact of robotic assistance, and treatment preferences. Multivariable logistic regression was performed to identify factors associated with preference for robotic-assisted surgery.
RESULTS
Most respondents believed robotic-assisted shoulder arthroplasty leads to greater implant positioning accuracy (74%), better outcomes (67%), fewer complications (61%), and faster recovery (54%) than conventional arthroplasty. Despite this favorable perception, enthusiasm softened when robotics was placed in direct competition with surgeon experience: 62% of respondents preferred a higher-volume surgeon who does not use robotics over a lower-volume surgeon who does. The leading concerns regarding robotic technology were equipment malfunction causing harm, increased cost, and surgeon inexperience with the technology. Seventy-six percent of respondents accurately understood the actual role of the robot in the operating room. Overall, 58% of respondents preferred robotic-assisted shoulder arthroplasty over a conventional manual approach. Perceived improvement in outcomes was the strongest independent predictor of preference for robotic-assisted surgery (OR 3.31, 95% CI 1.98-5.51). Other independently associated factors include, belief that robotics guarantees better results (OR 2.32, 95% CI 1.52-3.53), early technology adoption (OR 1.92, 95% CI 1.21-3.04), prior awareness of robotic-assisted shoulder arthroplasty (OR 1.90, 95% CI 1.19-3.02), and male sex (OR 1.49, 95% CI 1.03-2.15).
CONCLUSION
Public perceptions of robotic-assisted shoulder arthroplasty were generally favorable and closely tied to the belief that robotic assistance improves outcomes. These findings highlight the need to align public expectations with the limited available evidence through patient education and transparent shared decision-making as the use of this technology continues to expand.
LEVEL OF EVIDENCE
Survey Study, Public.