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Review
. 2020 Jun;13(3):309-317.
doi: 10.1007/s12178-020-09625-z.

Robots in the Operating Room During Hip and Knee Arthroplasty

Paul L Sousa  1 , Peter K Sculco  2 , David J Mayman  2 , Seth A Jerabek  2 , Michael P Ast  2 , Brian P Chalmers  3
Affiliations
Review

Robots in the Operating Room During Hip and Knee Arthroplasty

Paul L Sousa et al. Curr Rev Musculoskelet Med. 2020 Jun.

Abstract

Purpose of the review: The utilization of technology has increased over the last decade across all surgical specialties. Robotic-assisted surgery, among the most advanced surgical technology, applied to hip and knee arthroplasty has experienced rapid growth in utilization, surgical applications, and robotic platforms. The goal of this study is to provide a comprehensive review of the most commonly utilized robotic platforms for hip and knee arthroplasty and the most up to date literature on the benefits and limitations of robotic arthroplasty.

Recent findings: Studies consistently demonstrate that that robotic-assisted surgery during total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) improves component position and alignment. There is also growing evidence that robotic-assisted UKA improves clinical outcomes and implant survivorship and, therefore, may be cost-effective. However, there remains to be convincing evidence that robotic-assisted arthroplasty improves clinical outcome measures or reduces revision rates for THA and TKA. Potential disadvantages of robotic arthroplasty remain, including a learning curve, potential for additional radiation exposure preoperatively, and the financial costs. Robotic hip and knee arthroplasty remains attactive as studies show that it consistently improves implant position and alignment over conventional techniques. There is growing evidence that robotic UKA may improve patient outcomes and reduce revision rates, but further study is needed. In addition, further and longer-term studies are needed to determine if improved component position and alignment in TKA and THA leads to improved clinical outcomes and reduced revision rates.

Keywords: Clinical outcomes; Implant alignment; Robotics; Total hip replacement; Total knee replacement; Unicompartmental knee replacement.

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Conflict of interest statement

Brian Chalmers and Paul Sousa have nothing to disclose.

Peter Sculco is a paid consultant for Lima Coporate, Intellijoint Surgical, and EOS imaging; he has also received research support from Intellijoint Surgical.

David Mayman receives stock options from OrthAlign, Imagen, Insight, and Wishbone; he is a board member of the Knee Society; he is a paid consultant and has received research support from Smith and Nephew.

Seth Jerabek receives stock options from Imagen Technologies and has received research support, paid honoraria, consulting fees, and royalties from Stryker.

Michael Ast is a board member of AAHKS and EOA; he is a paid consultant for Stryker, Surgical Care Affiliates, Smith and Nephew, OrthAlign, and Conformis; he receives stock options from Osso VR and OrthAlign; he has received research support from Smith and Nephew.

Figures

Fig. 1
Fig. 1
Photographs of intraoperative acetabular component position planning (a) based on a preoperative CT scan and haptic guided acetabular reaming (b) with the Mako robototic system for a total hip arthroplasty
Fig. 2
Fig. 2
Photographs of intraoperative customization of implant positioning and alignment (a) after bony registration and utilization of the burring tool to prepare the bone (b) with the Navio robotic system for a unicompartmental knee arthroplasty
See this image and copyright information in PMC

References

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