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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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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Dr Tan Sok Chuen is an orthopaedic surgery specialist with subspecialty training in hip and knee surgery – making her the first female hip and knee replacement surgeon in Singapore. She has trained and educated junior doctors through various teaching programmes and courses. Dr Tan has also made many contributions to the scientific literature on hip and knee arthroplasty and her publications on trunnionosis in hip replacements are frequently quoted in indexed journals.
Dr Adrian Lau is a specialist orthopaedic surgeon trained in primary and complex hip and knee arthroplasty. His clinical practice comprises mainly of total knee replacements, total hip replacements, complex hip and knee replacements, revision surgeries, prosthetic joint infections, and periprosthetic fractures. Dr Lau also plays an active role in the education and training of junior doctors and is a recipient of numerous awards, one of them being the Ministry of Health Training Award in 2014.
Certain Orthopaedic procedures done at our Clinic is claimable under Medisave and Integrated Shield Plans.
Our doctors are trained and highly experienced in diagnosing and treating orthopaedic conditions of the knee. We aim to provide you with quality care by thoroughly assessing your condition and personalising your treatments to your needs and goals.