Zimmer Biomet Holdings, Inc. has completed its acquisition of Monogram Technologies Inc., an AI-driven orthopedic robotics company, for $177 million in a transaction that positions the medical technology leader to become the first orthopedic company to offer fully autonomous robotic solutions for surgical procedures.
The acquisition, announced on October 7, 2025, expands Zimmer Biomet's extensive suite of orthopedic robotics technologies by adding Monogram's surgeon-guided semi- and fully autonomous robotic capabilities to complement the company's existing ROSA® Robotics platform and other navigation solutions.
FDA-Cleared Technology Ready for Commercial Launch
Monogram has developed a CT-based, semi-autonomous, AI-navigated total knee arthroplasty (TKA) robotic technology that received FDA 510(k) clearance in March 2025. The technology is expected to be commercialized with Zimmer Biomet implants by early 2027, providing surgeons with advanced autonomous capabilities for knee replacement procedures.
"By bringing Monogram into the Zimmer Biomet innovation ecosystem, we have set a bold course to become the first orthopedic company to offer a fully autonomous robotic solution complementing our current robotic and navigation offerings," said Ivan Tornos, Chairman, President and Chief Executive Officer of Zimmer Biomet.
Advancing Toward Full Autonomy
Beyond the semi-autonomous system, Monogram began conducting a clinical study in July 2025 for the fully autonomous version of its technology, representing a significant advancement in orthopedic surgical robotics. This development could revolutionize surgical procedures by reducing surgeon intervention while maintaining precision and safety standards.
The acquisition creates what the company describes as "the broadest, most flexible portfolio of orthopedic robotics and navigation technologies," enabling Zimmer Biomet to address surgeon needs across pre-, intra- and post-operative care settings.
Comprehensive Robotics Portfolio
Zimmer Biomet's expanded robotics portfolio now includes imageless robotics through its ROSA® Robotics platform, a licensed CT-based handheld robot, mixed reality and AI-based navigation systems, and Monogram's semi- and fully autonomous robotics capabilities. The ROSA platform, which serves as the cornerstone of Zimmer Biomet's robotics offering, is rapidly approaching 2,000 installations worldwide and leads the market outside the United States.
The company is investing in a robust R&D pipeline featuring several new products and software applications expected between now and 2027, including ROSA Knee with OptimiZe™, which has been submitted to the FDA with 510(k) clearance anticipated later this year.
Transaction Structure and Financial Terms
Under the acquisition agreement dated July 11, 2025, each outstanding share of Monogram common stock was converted into $4.04 in cash plus non-tradeable contingent value rights (CVRs). These CVRs entitle holders to receive up to $12.37 in additional cash if certain product development, regulatory and revenue milestones are achieved through 2030.
With the acquisition complete, Monogram shares ceased trading on NASDAQ prior to market opening on October 7, 2025, and will be delisted from the exchange.
Strategic Impact on Orthopedic Surgery
The acquisition represents a significant step toward autonomous surgical robotics in orthopedics, potentially transforming how knee replacement surgeries are performed. Tornos emphasized the strategic importance of the transaction, stating that the company aims "to provide surgeons the broadest choice in robotics and navigation across a wide range of procedures and care settings."
The integration of Monogram's talent and technology is expected to accelerate Zimmer Biomet's innovation pipeline, deepen value to surgeons, and strengthen the company's long-term growth strategy in the competitive orthopedic robotics market.
