Knee prosthetic surgery has seen the introduction of new instruments in recent years that allow the surgery to be performed in a more reproducible and precise manner. A major advantage of these instruments, such as robot-assisted surgery, is that it makes it possible to perform the surgery with extreme reproducibility even in patients with altered anatomy.
The robot assists the experienced surgeon in performing prosthetic implant placement with extreme accuracy.

How does the robot work?

The surgeon, during the preoperative outpatient visit will prescribe appropriate tests that will allow accurate preoperative planning.
Preoperative planning consists of computer simulation of the surgery so that the size of the implant to be used can already be assessed, as well as in what position it will be placed to allow the best mobility of the patient in the postoperative period.

protesi di ginocchio innovative e con il robot
Fig. 1 The robot is set up with the position of the knee in the operating room
protesi di ginocchio innovative e con il robot
Fig. 2 The robot assists the surgeon in guiding him along the bone cuts necessary for the placement of the prosthetic implant.

Is a robot-implanted prosthesis different than a traditionally implanted prosthesis?

No, however, the extreme precision of the robot often allows for shorter hospital and rehabilitation times due to tissue sparing possible when working with such precise technology. The complication rate was lower (0.7 percent versus 2.4 percent), and the average length of stay was shorter (1.2 versus 2.2 days), according to results presented at the 2019 AAOS (American Academy of Orthopaedic Surgeons) annual meeting. [1-4]

What are the disadvantages of robotic knee surgery?

There are few disadvantages at present, but the main one is a slight increase in operative duration, which is 10 minutes longer on average when surgeons experienced in the robotic technique are operating.

Based on this planning, the robot is instructed about the position of the knee in the operating room (Fig. 1), and will help the surgeon in guiding it along the bone cuts necessary for implant placement (Fig. 2).

What prostheses can be implanted with the robot?

Any type of knee prosthesis can be implanted with the robot, from a single-compartment prosthesis (mini-prosthesis), to a primary prosthesis, to a revision prosthesis.

As in any case, however, evaluation by an orthopedic surgeon experienced in robotic knee surgery is necessary to ensure that our case benefits from the use of the surgical robot.

Radiografia in 2 proiezioni prima e dopo Protesi mono-compartimentale mediale eseguita con assistenza del Robot
Fig. 3 X-ray in 2 projections before and after Robot-assisted medial monocompartimental prosthesis

Curriculum of Prof. Marcheggiani Muccioli

Giulio Maria Marcheggiani Muccioli, MD, PhD has distinguished himself in the field of orthopedics, starting with a degree with honors in Medicine and Surgery, obtained from the University of Bologna in 2006, followed by a specialization with honors in Orthopedics and Traumatology at the Rizzoli Orthopedic Institute of Bologna and a PhD in Surgical Sciences.

His career includes the academic role of Associate Professor in Orthopedics at the Faculty of Medicine and Surgery of the University of Bologna, where he researches in the field of biomechanics and pathology of the lower and upper limbs.

He has expanded his skills through international fellowships, including experiences in the United Kingdom, Japan and USA, consolidating himself as an Orthopedic Surgeon with extensive practical experience (he performs over 250 operations per year).

Finally, he contributes significantly every year to the training of new generations of doctors through university teaching in multiple medical and surgical disciplines.

He is one of the 10 Italian surgeons who over the last 20 years have been selected by the American Knee Society to participate in the prestigious John Insall Fellowship on Prosthetic Knee Surgery.

His wrote over 250 scientific publications. He attended more than 100 international meetings. This demonstrates his commitment towards innovation in the treatment of knee and shoulder pathologies, and in the advancement of new surgical techniques.

Bibliography
  1. Robotic-assisted Medial Unicompartmental Knee Arthroplasty: Options and Outcomes. Lonner, Jess H.; Klement, Mitchell R. Journal of the American Academy of Orthopaedic Surgeons. 2019 Mar; 27(5):e207-e214.

  2. Robot-assisted vs. conventional unicompartmental knee arthroplasty : Systematic review and meta-analysis. Fu J, Wang Y, Li X, Yu B, Ni M, Chai W, Hao L, Chen J. Orthopade. 2018 Dec;47(12):1009-1017.

  3. Robotic-Assisted Unicompartmental Knee Arthroplasty: State-of-the Art and Review of the Literature. Christ AB, Pearle AD, Mayman DJ, Haas SB. J Arthroplasty. 2018 Jul;33(7):1994-2001.

  4. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Knee Surg Sports Traumatol Arthrosc. 2019 Apr;27(4):1232-1240.

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