mBos TKA System vs ROSA in 2026

mBos TKA System

The Monogram mBos TKA System is a robotic total-knee-arthroplasty platform from Monogram Technologies, a Zimmer Biomet subsidiary since October 2025. It is the autonomy-boundary case of DEPLOY's surgical cluster: unlike the AI-augmented, surgeon-controlled systems (Stryker Mako, Smith+Nephew CORI, Zimmer Biomet ROSA), where the surgeon makes the cuts, the cleared mBos is semi-autonomous, with a robotic arm (built on a KUKA arm) executing the bone cuts itself under AI control within a surgeon-approved, patient-specific CT-based plan and active surgeon supervision.

There is no consumer price: it is pre-commercial enterprise surgical equipment that has not sold any units. Several verified-vs-claimed cap-flags matter. It received FDA 510(k) clearance on March 17, 2025, but the exact K-number could not be independently verified, and the 'semi-autonomous' characterization is sourced to Zimmer Biomet and trade coverage rather than the FDA letter (Monogram's own clearance release described it more softly as robotic-assisted TKA).

A separate fully-autonomous, hands-free, saw-based version is not FDA cleared and remains in development, targeted around late 2027 or 2028; its first live-patient procedure (July 26, 2025, Ahmedabad, India) was under an India CDSCO 102-procedure investigation, not US FDA, a single index case with no verified peer-reviewed outcomes. Monogram was founded by orthopedic surgeon Dr.

Doug Unis (chief medical officer and founder, not CEO; the pre-acquisition CEO was Benjamin Sexson) and was acquired by Zimmer Biomet at about $168M enterprise value plus contingent value rights, with commercialization alongside Zimmer Biomet implants targeted for early 2027. The registry records it at research maturity: cleared but pre-commercial, with its headline fully-autonomous capability still in development.

ROSA

Zimmer Biomet's ROSA (Robotic Surgical Assistant) is a single articulated robotic arm coupled to optical navigation and 2D/3D planning software, and the mid-size, cross-domain archetype of the orthopedic sub-cohort: it spans orthopedics and neurosurgery. The arm positions and guides instruments but moves only on surgeon command; it does not cut or place autonomously (AI-augmented, surgeon-controlled).

Current Zimmer Biomet variants are ROSA Knee (total knee arthroplasty, imageless X-Atlas workflow, cleared January 25, 2019; 'ROSA Knee with OptimiZe' cleared November 14, 2025), ROSA Hip (direct-anterior total hip arthroplasty specifically, cleared August 18, 2021), ROSA ONE Brain (cranial neurosurgery: biopsy, SEEG, DBS, and endoscopy, cleared February 11, 2019), and ROSA Shoulder (cleared February 2024). Made by Zimmer Biomet (NYSE: ZBH).

Two cap-flags: ROSA Spine is not a current Zimmer Biomet variant (it left in the 2022 ZimVie spinoff), and Zimmer Biomet's autonomy ambitions run through its separate Monogram acquisition, not ROSA. As enterprise B2B surgical equipment, there is no consumer price.