Robotic assisted Knee Arthroplasty

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 Il robot viene istruito riguardo la posizione del ginocchio in sala operatoria.
protesi di ginocchio innovative e con il robot
Fig. 2 Il robot aiuta il chirurgo nel guidarlo lungo i tagli ossei necessari per il posizionamento dell’impianto protesico.

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
Radiografia in 2 proiezioni prima e dopo Protesi mono-compartimentale mediale eseguita con assistenza del Robot
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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