Impact of robotic total hip and knee arthroplasty on resident and fellow training in orthopedic surgery.

Robotic-assisted total joint arthroplasty (RA-TJA) has experienced rapid growth in adoption and is reshaping orthopedic surgical practice. Despite offering potential for improved precision, reproducibility, and intraoperative feedback, its integration into orthopedic training has raised questions about educational equity and quality, manual skill development, and trainee autonomy. This review examines the educational implications of RA-TJA on orthopedic residency and fellowship training. The goal is to synthesize existing literature on RA-TJA impact on technical skill acquisition, surgical exposure, operative autonomy, and cognitive engagement, with attention to global disparities and the role of simulation in modern training models. A narrative literature review was conducted, focusing on empirical studies, trainee surveys, and expert opinion related to robotic systems in arthroplasty education. Specific attention was given to competency-based medical education (CBME) frameworks, intraoperative performance metrics, simulation-based learning, and institutional variability. Robotic systems facilitate early technical proficiency by offering structured intraoperative workflows and objective metrics, aligning well with CBME. These platforms enhance resident involvement in preoperative planning and spatial understanding but may inadvertently reduce manual versatility and intraoperative decision-making without complementary training in conventional techniques. Trainee autonomy varies significantly by institution, and access to RA-TJA during post-graduate medical education remains inconsistent. Simulation technologies, particularly virtual reality, represent scalable solutions to bridge training gaps but require standardized integration, assessment models, and certification pathways. RA-TJA presents both opportunities and challenges for orthopedic education. Its successful implementation requires deliberate curricular design, hybrid exposure to both robotic and manual techniques, and equitable access to simulation-based resources. Moving forward, training standardization, integration of performance-based progression metrics, and global cooperation will be essential to preparing orthopedic surgeons for the evolving digital surgical landscape.