Robotic Assisted Total Knee Replacement Surgery
Written by Fabio Orozco, MD, Board Certified Orthopaedic Surgeon
Robotic technology has paved the way for quicker production and efficiency in our society across all industries from cars to food, to shopping and of course healthcare. Incorporating robotics leads to reproducible results, accuracy, and enhances outcomes. Healthcare incorporates robotics in pharmaceutical production, medical equipment manufacturing, and during surgical procedures. Since the 1980s, surgical procedures have been utilizing robotics to decrease trauma to surrounding tissues, precision cuts, and smaller less invasive incisions across all specialties. Joint replacements have seen a 500% increase in the use of robotic assisted surgery from 2009 to 2013 with that number continuing to rise. Almost every joint replacement manufacturer has developed a robotic system to be used with their implants, however robotic assisted surgery still only makes up less than 25% of all joint replacement surgeries. First, let us discuss what robotic surgery is NOT. The robot does not perform the surgery. My kids would love this so I could be home more, but the truth is, the robot is a robotic arm that the surgeon guides to create the cuts in the bone for a proper fit and alignment. Joint replacement surgery is still performed by the surgeon using his experience and knowledge. The advantage of robotic surgery is it brings the best technology available today to be more precise, more accurate and more predictable. Robotics enables the surgeon to cut away only the bone needed to fit the prothesis like a glove, sparing healthy tissue. This exactness creates the least amount of trauma and decreases complications. Robotics allows surgeons to place the prosthetic components in the best possible position using exact measurements determined by a pre-operative CT Scan. This leads to the ability for many joint replacements to be fixated without the need of cement which can breakdown over time. Cementless joint replacements last much longer, potentially many decades or even one’s life expectancy. Traditionally, total knee replacement surgery planning starts with an x-ray. A template is created using these 2-D images and then the surgeon uses his skill
and experience to determine the prothesis, sizing and placement. Most of these decisions are made during surgery, with template sizes that can be trialed before the actual prothesis is placed. With robotics, much of the surgical planning is done prior to the patient even stepping foot in the operating room. A special 3-D CT scan is performed a least two weeks before surgery which is then used to determine component sizing, balancing the ligaments and realignment of the leg. During surgery, the surgeon as the opportunity to make millimeter changes during the procedure to perfectly balance the knee. Current research is consistently showing superior results with the use of robotic surgery compared to traditional instrumentation. In one such study by Bone and Joint Research in 2019, the authors found that the use of robotic assisted surgery decreased hospital stays by more than a full day. Robotic total knee replacement patients had less postoperative pain, required less pain medication, had increased flexion and quad strength sooner than traditional total knee replacement. These patients also required less physical therapy and had a quicker recovery. Robotic assisted surgery carries significant benefits for the patient and the surgeon. Robotic surgery makes the surgeon better, creates reproducible results, enhances the visual surgical field, and provides a great deal of detail prior to surgery to finalize the surgical plan. The patients benefit from robotics by having less pain, quicker recoveries, and less complications. Robotic surgery will continue to grow as more and more surgeons transition to robotic assisted surgery to enhance the patient experience.
For more information contact us: 609-300-7779.
Dr. Fabio Orozco is a board-certified hip and knee surgeon with over 15 years of experience. Dr. Orozco has helped over ten thousand people get their lives back through surgery. Dr. Orozco is an expert in robotic surgery and uses the latest less-invasive surgical techniques, including direct anterior hip replacement and quadriceps-sparing partial and total knee replacements. He serves as the Director of Orthopaedic Surgery at AtlantiCare Regional Medical Center.
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