Damian Clark a Bristol knee surgeon and 3 nurses standing in theatre with the robotic-assisted knee replacement technology

15 Oct Robotic-assisted knee replacement in Bristol

Posted at 12:39h in Patients by

Robotic-assisted knee replacement is now available to patients in Bristol. This innovative technology is proving a successful alternative to conventional surgery.

 

Does robotic-assisted knee replacement technology take over the surgeon’s role?

 

This is the question I hear most often. Actually, the surgeon is more involved than ever, but with more information available and greater accuracy. Surgeons call this robotic-assisted knee replacement technology the “robot” but in fact, it is an improvement in the whole process. A 3D scan permits very accurate planning of the implant placement. The scan is then matched with the robot with infrared positioning technology, this permits the robot to know the precise position of the leg in space. The surgeon prepares the surgical field for the bone cuts and then the robot guides the surgeon in making the bone cuts.

 

What are the advantages?

 

Greater accuracy means less disturbance of the knee and faster recovery. Two laboratory studies found that the Mako Total Knee enabled surgeons to execute their surgical plans with greater accuracy.1,2 In one clinical study, robotic-assisted surgery enabled protection of soft tissue and ligaments from damage.3 In a clinical study, patients who had undergone robotic-assisted knee had lower pain scores and greater satisfaction scores than those who received a standard knee replacement.4

 

What are the limitations?

 

Total knee replacement remains one of several options. The robot does not protect against all of the possible problems that can arise from surgery. Careful treatment selection pre-operatively and postoperative rehabilitation and physiotherapy remains a key element of the process.

 

References
  1. Haddad, Fares. How Procedural Innovation Has Changed My Practice: Mako TKA. World Arthroplasty Congress Rome, IT April 2018
  2. Hampp EL, Scholl LY, Chang TC, et al Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy to plan compared to manual technique. 17th annual CAOS Meeting, June 2017, Vol 1, 2017; 1-5.
  3. Kayani B., Konan S., Pietrziek J., Haddad F. S. Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared With Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System. “https://www.ncbi.nlm.nih.gov/pubmed/29699827” J Arthroplasty. 2018 Aug;33(8):2496-2501.
  4. Marchand RC, Sodhi N, Khlopas A, Sultan AA, Harwin SF, Malkani AL, Mont MM. Patient satisfaction outcomes after robotic-arm assisted total knee arthroplasty: a short-term evaluation. J Knee Surg. 2017 Nov;30(9):849-853.

 

Further reading

Iatrogenic Bone and Soft Tissue Trauma in Robotic-Arm Assisted Total Knee Arthroplasty Compared With Conventional Jig-Based Total Knee Arthroplasty: A Prospective Cohort Study and Validation of a New Classification System.

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