Abstract
<jats:p>Imageless robotic-assisted total knee arthroplasty (TKA) systems represent a significant advancement in addressing the inherent limitations of conventional techniques and image‐dependent robotic systems. By relying on intraoperative data acquisition through the registration of anatomical landmarks, these systems allow real-time surgical planning with reduced radiation exposure and decreased preoperative preparation. The present review discusses imageless robotic-assisted TKA (rTKA) platforms. Evidence from multiple studies indicates that these systems can improve alignment accuracy, reduce the incidence of outlier implant positions, and offer a short learning curve; however, challenges such as increased operative time, blood loss, and early complications have been reported. In the subsequent sections, we provide an overview of current imageless robotic TKA technologies, a detailed synthesis of the evidence related to surgical efficacy and accuracy, a discussion on complications and technical limitations, and suggestions for future research directions.</jats:p>