On Robotic Surgery in Knee Arthroplasty: Beginning of a New Era
,
Abstract
During the past two decades, the use of robotic arms in knee arthroplasty has changed from a concept to a reality. These systems promise precision and accuracy while shortening the required learning curve. Although still largely in the early stages, there are currently several commercially available platforms with varying degrees of flexibility. The available models can be classified into several categories based on their mode of operation (whether the system requires imaging input) and degree of autonomy. The present study aimed to review the existing body of literature and provide an outlook of the current landscape. The strengths and weaknesses of the implementation of such systems in knee arthroplasty are also discussed.
1. Davies BL, Hibberd RD, Ng WS, Timoney AG, Wickham JE. The development of a surgeon robot for prostatectomies. Proc Inst Mech Eng H. 1991;205(1):35-8. doi: 10.1243/PIME_PROC_1991_205_259_02. [PubMed: 1670073].
2. Goldsmith MF. For better hip replacement results, surgeon's best friend may be a robot. JAMA. 1992;267(5):613-4. [PubMed: 1731119].
3. Innocenti B, Bori E. Robotics in orthopaedic surgery: Why, what and how? Arch Orthop Trauma Surg. 2021;141(12):2035-42. doi: 10.1007/s00402-021-04046-0. [PubMed: 34255170].
4. Khlopas A, Sodhi N, Sultan AA, Chughtai M, Molloy RM, Mont MA. Robotic arm-assisted total knee arthroplasty. J Arthroplasty. 2018;33(7):2002-6. doi: 10.1016/j.arth.2018.01.060. [PubMed: 29506926].
5. Pailhe R. Total knee arthroplasty: Latest robotics implantation techniques. Orthop Traumatol Surg Res. 2021;107(1S):102780. doi: 10.1016/j.otsr.2020.102780. [PubMed: 33333275].
6. Onggo JR, Onggo JD, De Steiger R, Hau R. Robotic-assisted total knee arthroplasty is comparable to conventional total knee arthroplasty: A meta-analysis and systematic review. Arch Orthop Trauma Surg. 2020;140(10):1533-49. doi: 10.1007/s00402- 020-03512-5. [PubMed: 32537660].
7. Bautista M, Manrique J, Hozack WJ. Robotics in total kneearthroplasty. J Knee Surg. 2019;32(7):600-6. doi: 10.1055/s-0039-
1681053. [PubMed: 30822790].
8. Kayani B, Konan S, Ayuob A, Onochie E, Al-Jabri T, Haddad FS.
Robotic technology in total knee arthroplasty: A systematic review. EFORT Open Rev. 2019;4(10):611-7. doi: 10.1302/2058- 5241.4.190022. [PubMed: 31754467]. [PubMed Central: PMC6836078].
9. Bagaria V, Sadigale OS, Pawar PP, Bashyal RK, Achalare A, Poduval M. Robotic-assisted knee arthroplasty (RAKA): The technique, the technology and the transition. Indian J Orthop. 2020;54(6):745-56. doi: 10.1007/s43465-020-00088-5. [PubMed: 33133397]. [PubMed Central: PMC7572961].
10. Buza JA, Vigdorchik J, Schwarzkopf R. Robotics and the modern total knee arthroplasty. Techniques in Orthopaedics. 2018;33(1):66-70. doi: 10.1097/BTO.0000000000000279.
11. Stulberg BN, Zadzilka JD. Active robotic technologies for total knee arthroplasty. Arch Orthop Trauma Surg. 2021;141(12): 2069-75. doi: 10.1007/s00402-021-04044-2. [PubMed: 34259928].
12. Liow MHL, Goh GS, Wong MK, Chin PL, Tay DK, Yeo SJ. Robotic- assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(9):2942-51. doi: 10.1007/s00167-016-4076-3. [PubMed: 27017214].
13. Behery OA, Stulberg B, Kreuzer S, Kissin Y, Campanelli V, Vigdorchik JM, et al. Component position accuracy in active robotic total knee arthroplasty. Orthop Procs. 2018; 100-B(Suppl_12):24-24. doi: 10.1302/1358-992X.2018.12.024.
14. Koulalis D, O'Loughlin PF, Plaskos C, Kendoff D, Cross MB, Pearle AD. Sequential versus automated cutting guides in computer- assisted total knee arthroplasty. Knee. 2011;18(6):436-42. doi: 10.1016/j.knee.2010.08.007. [PubMed: 20837395].
15. Suero EM, Plaskos C, Dixon PL, Pearle AD. Adjustable cutting blocks improve alignment and surgical time in computer- assisted total knee replacement. Knee Surg Sports Traumatol Arthrosc. 2012;20(9):1736-41. doi: 10.1007/s00167-011-1752-1. [PubMed: 22116262].
16. Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. Preliminary experience with an image-free handheld robot for total knee arthroplasty: 77 cases compared with a matched control group. Eur J Orthop Surg Traumatol. 2020;30(4):723-9. doi: 10.1007/s00590-020-02624-3. [PubMed: 31950265].
17. Lonner JH, John TK, Conditt MA. Robotic arm-assisted UKA improves tibial component alignment: A pilot study. Clin Orthop Relat Res. 2010;468(1):141-6. doi: 10.1007/s11999-009-0977-5. [PubMed: 19593669]. [PubMed Central: PMC2795844].
18. Sinha RK. Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. Am J Orthop (Belle Mead NJ). 2009;38(2 Suppl):20-2. [PubMed: 19340379].
19. Sires JD, Craik JD, Wilson CJ. Accuracy of bone resection in MAKO total knee robotic-assisted surgery. J Knee Surg. 2021;34(7):745-8. doi: 10.1055/s-0039-1700570. [PubMed: 31694057].
20. Kayani B, Konan S, Huq SS, Tahmassebi J, Haddad FS. Robotic- arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1132-41. doi: 10.1007/s00167-018-5138-5. [PubMed: 30225554]. [PubMed Central: PMC6435632].
21. Batailler C, Hannouche D, Benazzo F, Parratte S. Concepts and techniques of a new robotically assisted technique for total knee arthroplasty: the ROSA knee system. Arch Orthop Trauma Surg. 2021;141(12):2049-58. doi: 10.1007/s00402-021-04048-y. [PubMed: 34255173].
22. Parratte S, Price AJ, Jeys LM, Jackson WF, Clarke HD. Accuracy of a new robotically assisted technique for total knee arthroplasty: A cadaveric study. J Arthroplasty. 2019;34(11):2799-803. doi: 10.1016/j.arth.2019.06.040. [PubMed: 31301912].
23. Pugely AJ, Martin CT, Gao Y, Schweizer ML, Callaghan JJ. The incidence of and risk factors for 30-day surgical site infections following primary and revision total joint arthroplasty. J Arthroplasty. 2015;30(9 Suppl):47-50. doi: 10.1016/j.arth.2015.01.063. [PubMed: 26071247].
24. Peersman G, Laskin R, Davis J, Peterson MG, Richart T. Prolonged operative time correlates with increased infection rate after total knee arthroplasty. HSS J. 2006;2(1):70-2. doi: 10.1007/s11420-005-0130-2. [PubMed: 18751850]. [PubMed Central: PMC2504110].
25. Liow MH, Xia Z, Wong MK, Tay KJ, Yeo SJ, Chin PL. Robot- assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study. J Arthroplasty. 2014;29(12):2373-7. doi: 10.1016/j.arth.2013.12.010. [PubMed: 24439796].
26. Song EK, Seon JK, Park SJ, Jung WB, Park HW, Lee GW. Simultaneous bilateral total knee arthroplasty with robotic and conventional techniques: A prospective, randomized study. Knee Surg Sports Traumatol Arthrosc. 2011;19(7): 1069-76. doi: 10.1007/s00167-011-1400-9. [PubMed: 21311869].
27. Siebert W, Mai S, Kober R, Heeckt PF. Technique and first clinical results of robot-assisted total knee replacement. Knee. 2002;9(3): 173-80. doi: 10.1016/s0968-0160(02)00015-7. [PubMed: 12126674].
28. Coon TM. Integrating robotic technology into the operating room. Am J Orthop (Belle Mead NJ). 2009;38(2 Suppl):7-9. [PubMed: 19340376].
2. Goldsmith MF. For better hip replacement results, surgeon's best friend may be a robot. JAMA. 1992;267(5):613-4. [PubMed: 1731119].
3. Innocenti B, Bori E. Robotics in orthopaedic surgery: Why, what and how? Arch Orthop Trauma Surg. 2021;141(12):2035-42. doi: 10.1007/s00402-021-04046-0. [PubMed: 34255170].
4. Khlopas A, Sodhi N, Sultan AA, Chughtai M, Molloy RM, Mont MA. Robotic arm-assisted total knee arthroplasty. J Arthroplasty. 2018;33(7):2002-6. doi: 10.1016/j.arth.2018.01.060. [PubMed: 29506926].
5. Pailhe R. Total knee arthroplasty: Latest robotics implantation techniques. Orthop Traumatol Surg Res. 2021;107(1S):102780. doi: 10.1016/j.otsr.2020.102780. [PubMed: 33333275].
6. Onggo JR, Onggo JD, De Steiger R, Hau R. Robotic-assisted total knee arthroplasty is comparable to conventional total knee arthroplasty: A meta-analysis and systematic review. Arch Orthop Trauma Surg. 2020;140(10):1533-49. doi: 10.1007/s00402- 020-03512-5. [PubMed: 32537660].
7. Bautista M, Manrique J, Hozack WJ. Robotics in total kneearthroplasty. J Knee Surg. 2019;32(7):600-6. doi: 10.1055/s-0039-
1681053. [PubMed: 30822790].
8. Kayani B, Konan S, Ayuob A, Onochie E, Al-Jabri T, Haddad FS.
Robotic technology in total knee arthroplasty: A systematic review. EFORT Open Rev. 2019;4(10):611-7. doi: 10.1302/2058- 5241.4.190022. [PubMed: 31754467]. [PubMed Central: PMC6836078].
9. Bagaria V, Sadigale OS, Pawar PP, Bashyal RK, Achalare A, Poduval M. Robotic-assisted knee arthroplasty (RAKA): The technique, the technology and the transition. Indian J Orthop. 2020;54(6):745-56. doi: 10.1007/s43465-020-00088-5. [PubMed: 33133397]. [PubMed Central: PMC7572961].
10. Buza JA, Vigdorchik J, Schwarzkopf R. Robotics and the modern total knee arthroplasty. Techniques in Orthopaedics. 2018;33(1):66-70. doi: 10.1097/BTO.0000000000000279.
11. Stulberg BN, Zadzilka JD. Active robotic technologies for total knee arthroplasty. Arch Orthop Trauma Surg. 2021;141(12): 2069-75. doi: 10.1007/s00402-021-04044-2. [PubMed: 34259928].
12. Liow MHL, Goh GS, Wong MK, Chin PL, Tay DK, Yeo SJ. Robotic- assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial. Knee Surg Sports Traumatol Arthrosc. 2017;25(9):2942-51. doi: 10.1007/s00167-016-4076-3. [PubMed: 27017214].
13. Behery OA, Stulberg B, Kreuzer S, Kissin Y, Campanelli V, Vigdorchik JM, et al. Component position accuracy in active robotic total knee arthroplasty. Orthop Procs. 2018; 100-B(Suppl_12):24-24. doi: 10.1302/1358-992X.2018.12.024.
14. Koulalis D, O'Loughlin PF, Plaskos C, Kendoff D, Cross MB, Pearle AD. Sequential versus automated cutting guides in computer- assisted total knee arthroplasty. Knee. 2011;18(6):436-42. doi: 10.1016/j.knee.2010.08.007. [PubMed: 20837395].
15. Suero EM, Plaskos C, Dixon PL, Pearle AD. Adjustable cutting blocks improve alignment and surgical time in computer- assisted total knee replacement. Knee Surg Sports Traumatol Arthrosc. 2012;20(9):1736-41. doi: 10.1007/s00167-011-1752-1. [PubMed: 22116262].
16. Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. Preliminary experience with an image-free handheld robot for total knee arthroplasty: 77 cases compared with a matched control group. Eur J Orthop Surg Traumatol. 2020;30(4):723-9. doi: 10.1007/s00590-020-02624-3. [PubMed: 31950265].
17. Lonner JH, John TK, Conditt MA. Robotic arm-assisted UKA improves tibial component alignment: A pilot study. Clin Orthop Relat Res. 2010;468(1):141-6. doi: 10.1007/s11999-009-0977-5. [PubMed: 19593669]. [PubMed Central: PMC2795844].
18. Sinha RK. Outcomes of robotic arm-assisted unicompartmental knee arthroplasty. Am J Orthop (Belle Mead NJ). 2009;38(2 Suppl):20-2. [PubMed: 19340379].
19. Sires JD, Craik JD, Wilson CJ. Accuracy of bone resection in MAKO total knee robotic-assisted surgery. J Knee Surg. 2021;34(7):745-8. doi: 10.1055/s-0039-1700570. [PubMed: 31694057].
20. Kayani B, Konan S, Huq SS, Tahmassebi J, Haddad FS. Robotic- arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1132-41. doi: 10.1007/s00167-018-5138-5. [PubMed: 30225554]. [PubMed Central: PMC6435632].
21. Batailler C, Hannouche D, Benazzo F, Parratte S. Concepts and techniques of a new robotically assisted technique for total knee arthroplasty: the ROSA knee system. Arch Orthop Trauma Surg. 2021;141(12):2049-58. doi: 10.1007/s00402-021-04048-y. [PubMed: 34255173].
22. Parratte S, Price AJ, Jeys LM, Jackson WF, Clarke HD. Accuracy of a new robotically assisted technique for total knee arthroplasty: A cadaveric study. J Arthroplasty. 2019;34(11):2799-803. doi: 10.1016/j.arth.2019.06.040. [PubMed: 31301912].
23. Pugely AJ, Martin CT, Gao Y, Schweizer ML, Callaghan JJ. The incidence of and risk factors for 30-day surgical site infections following primary and revision total joint arthroplasty. J Arthroplasty. 2015;30(9 Suppl):47-50. doi: 10.1016/j.arth.2015.01.063. [PubMed: 26071247].
24. Peersman G, Laskin R, Davis J, Peterson MG, Richart T. Prolonged operative time correlates with increased infection rate after total knee arthroplasty. HSS J. 2006;2(1):70-2. doi: 10.1007/s11420-005-0130-2. [PubMed: 18751850]. [PubMed Central: PMC2504110].
25. Liow MH, Xia Z, Wong MK, Tay KJ, Yeo SJ, Chin PL. Robot- assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study. J Arthroplasty. 2014;29(12):2373-7. doi: 10.1016/j.arth.2013.12.010. [PubMed: 24439796].
26. Song EK, Seon JK, Park SJ, Jung WB, Park HW, Lee GW. Simultaneous bilateral total knee arthroplasty with robotic and conventional techniques: A prospective, randomized study. Knee Surg Sports Traumatol Arthrosc. 2011;19(7): 1069-76. doi: 10.1007/s00167-011-1400-9. [PubMed: 21311869].
27. Siebert W, Mai S, Kober R, Heeckt PF. Technique and first clinical results of robot-assisted total knee replacement. Knee. 2002;9(3): 173-80. doi: 10.1016/s0968-0160(02)00015-7. [PubMed: 12126674].
28. Coon TM. Integrating robotic technology into the operating room. Am J Orthop (Belle Mead NJ). 2009;38(2 Suppl):7-9. [PubMed: 19340376].
| Files | ||
| Issue | Vol 10 No 1 (2024) | |
| Section | Educational Corner | |
| DOI | https://doi.org/10.18502/jost.v10i1.14968 | |
| Keywords | ||
| Robotic Surgery Arthroplasty Knee Replacement | ||
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How to Cite
1.
Sherafat Vaziri A, Javidmehr S, Vosoughi F, Babaei Nejad E, Same K. On Robotic Surgery in Knee Arthroplasty: Beginning of a New Era. J Orthop Spine Trauma. 2024;10(1):31-4.
