2026 AAHKS Annual Meeting: Robotic Assistance Reduces Cognitive Load During Arthroplasty: A Real-Time Brain Imaging Study

7 experienced orthopaedic surgeons performed 47 total hip and knee arthroplasty procedures using conventional techniques (n=17) or robotic assistance (n=30). The primary outcome of interest was surgeon cognitive load, assessed through intraoperative brain activity using functional near-infrared spectroscopy (fNIRS). Secondary outcomes included physiological stress, assessed using heart rate variability, and frontoparietal functional connectivity. Outcomes were assessed continuously during surgery and across specific operative stages. Overall, the results revealed that robotic-assisted arthroplasty was associated with increased parasympathetic activity and significantly reduced connectivity between the right dorsolateral prefrontal cortex (DLPFC) and left parietal region compared to conventional surgery. These findings suggested that robotic assistance may reduce physiological stress and cognitive demands on surgeons during arthroplasty.