What is Robotic Joint Replacement?

There is increasing interest in the use of robotic technology in healthcare and rightly so. Robots have improved the efficiency of many of our work processes and also the predictability of outcomes.

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robotic knee replacement surgery

 

ROBOTIC JOINT SURGERY

In the area of orthopaedic surgery, robots can be classified into three categories: passive robots, haptic robots, and autonomous robots. Passive robots are computer-assisted systems which provide the surgeon with real-time 3D data on the surgical field, guiding surgical decision making. Haptic systems (also known as Robot-Assisted Minimally Invasive Surgical (RAMIS) systems) provide, in addition to passive systems, precision in instrumentation and bony cuts, such that the robot becomes an extension of the surgeon’s hands. RAMIS systems constraint the surgeon’s hands to a predefined plan. An example of the RAMIS system is the MAKOplasty robot. Finally, autonomous systems perform the surgery independently after the surgeon has entered the data and surgical plan. An example of the autonomous robot is ROBODOC.

 

Scientific evidence has shown that RAMIS-type robots can improve surgical outcomes. A meta-analysis by Agarwal et al found that for total knee arthroplasty, robot-assisted total knee arthroplasty improved Hospital for Special Surgery Scores (HSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores when compared with conventional surgical approaches. Robot-assisted surgery in knee replacement surgery has also been found to significantly improve precision, and reduce incidence of mechanical misalignment (1,2).

 

Robotic joint surgery also enhances safety as important structures such as major arteries and ligaments are protected by the haptic mechanism of the robotic arm. Thus should help to avoid major mishaps of implant surgery.

 

Despite general ease of use, surgeons do need to be familiar with the robotic systems, know how to interpret the data, perform accurate registration of bony landmarks and know how to troubleshoot when things do not go according to plan for eg poor bone quality found during surgery.

 

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References:

  1. Agarwal N, To K, McDonnell S, Khan W. Clinical and Radiological Outcomes in Robotic-Assisted Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty. 2020 Nov 1:35(11):3393-3409e2.
  2. Chin B, Chua K, Budiono GR, Syn N, O’Neill GK. Robot-Assisted versus Conventional Total and Unicompartmental Knee Arthroplasty: A Meta-analysis of Radiological and Functional Outcomes. J Knee Surg 2020 Mar 17.

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