Robotic Vs Traditional Knee Replacement Surgery
Traditional knee replacement utilizes X-ray images and relies upon a surgeon’s visual evaluation of a knee, as well as direct manual surgery.
A robotic knee replacement surgery utilized for Kozlo, referred to as MAKOplasty, includes CT scanning that permits a surgeon to build a virtual model of a patient’s knee and create a pre-op plan. With computer help, a surgeon guides a programmed robotic arm in resurfacing a damaged knee part.
In both techniques, surgeons place metal components upon the ends of the tibia and thigh bone. Those metal pieces get cemented into place. Next, a surgeon puts a plastic insert between the metal parts to permit seamless knee movement.
Partial knee replacement is being performed more and more as an outpatient procedure.
What is traditional knee replacement?
Traditional knee replacement (also referred to as knee arthroplasty) involves a common orthopaedic treatment that’s used to replace the worn or damaged knee surfaces. Replacing those surfaces using a “prosthesis” or implant will alleviate pain and boost mobility, permitting patients to go back to normal, daily activities.
The traditional knee replacement approach utilizes a long vertical incision within the middle of the knee to access and view the joint. Minimally invasive knee replacement is a variant of this technique. A surgeon utilizes a shorter incision and a less-invasive, different method that exposes the joint—with the aim of decreasing post-op discomfort and speeding recovery.
What is robotic knee replacement?
MAKOplasty® knee replacement involves an innovative procedure choice for those who live with early to middle-stage osteoarthritis within the inner, top or outer knee compartments. It’s powered by RIO® Robotic Arm Interactive Orthopedic System that permits for steadily reproducible precision in conducting partial knee resurfacing.
Within the treatment, the diseased part of the knee gets resurfaced, sparing a patient’s healthy bone, as well as surrounding tissue. Then, an implant is secured inside the joint to enable the knee to smoothly move again.
Patients Who Might Benefit from Robotic-Assisted Knee Replacement
Partial replacement surgery can be defined as replacement of one or even two of the three knee compartments. Patients qualified for knee replacement, whether robot- assisted or not, usually have less serious arthritis, deformity or stiffness of the knee than those who need total knee replacement. Also, they are usually more active and younger.
Robotic-Assisted Knee Replacement Benefits
Robotic-assisted surgery’s precision permits:
- The possibility for improved long-range function
- Smaller incisions, which may mean a faster recovery, a briefer hospitalization and less discomfort
- Improved safety and decreased injury risk to surrounding tissues
- More accurate implant positioning, resulting in a more natural feeling after the procedure
Before the surgery, surgeons capture digital CT (computed tomography) scans of the knee. This information enables surgeons to figure out where to place the implant.
Within the procedure, a surgeon utilizes the robotic arm to precisely shape the adjacent bone before they place the implant. Real-time video images offer visual reinforcement, helping surgeons navigate hard-to-view areas.
The system, at the same time, uses the computed tomography image data to make a predefined, 3-D “envelope” of space where a surgeon works. The robotic arm only will operate inside that predefined space, so there isn’t any opportunity of an instrument slipping and injuring surrounding tissues.
Robotic-Assisted Knee Replacement Pros
MAKO technology has widely been welcomed and there are, undoubtedly, a multitude of benefits:
- It permits surgeons to make a customized surgical plan in order for them to position the implants with accuracy.
- Standard replacement joint prosthesis gets individually optimized to fit the person’s anatomy for more freedom from discomfort from any mismatch.
- Intraoperatively this system maps a patient’s patterns of natural joint movement and helps to minimize excess stress on the ligaments and soft tissues. It should ensure that they’ll have the ability to move in a natural way when the implant is placed.
- There seem to be fewer prosthesis complications after the procedure
- Rehab times are usually shorter.
- There’s less opportunity of implant failure with potential less necessity for revision procedure.
- Safety gets improved. With MAKO system turned on, surgeons only can perform within their pre-op strategies due to the robot limiting cutting outside the pre-planned space. It decreases human error’s risk.
- There’s a probability that blood loss might be decreased as there’s less unneeded exposed bone surface that is left to bleed.
Robotic-Assisted Knee Replacement Cons
Like any kind of procedure, MAKO isn’t without its downside.
- Surgical time is probably somewhat lengthier than with traditional joint replacements, which exposes patients to theoretically more infection risk.
- Any computerized system is just as good as the data that’s inputted into it. That includes the quality of the original CT scans, and proficiency of the team utilizing the MAKO system. Suitable experience and training help the process of workflow and optimally the end surgical outcome achieved.
- It’s a new technology for joint replacement implantation and, as a result, there’s only early proof to show long-range enhanced implant performance. Actual implants used already are traditionally tried and tested prostheses.
Benefits of Traditional Knee Replacement
The benefits of minimally invasive replacement surgery involve:
- Smaller scar
- Less post-op discomfort
- Less blood loss during the procedure
- Less damage to skin and adjacent soft tissue, which includes tendons, ligaments, and muscles
Downside of Traditional Replacement Surgery
- This less studied, newer surgical treatment might have unknown possible risks
- Typically, this procedure takes a longer period of time for surgeons to perform
- Soft tissue and skin may be torn and stretched during the procedure
- Potential increased likelihood that knee components might be misaligned or poorly fit
- Surgeon has a limited joint view; it’s a technically demanding procedure that has a steep surgical learning curve
In determining whether to choose traditional manual surgery or robotic-assisted surgery, patients must consult an orthopaedic expert who is able to provide updated advice, guidance and information.
1.Stevens-Lapsley JE, Bade MJ, Shulman BC, Kohrt WM, Dayton MR. Minimally Invasive Total Knee Arthroplasty Improves Early Knee Strength But Not Functional Performance: A Randomized Controlled Trial. J Arthroplasty. 2012 Mar 27. [Epub ahead of print] PubMed PMID: 22459124; PubMed Central PMCID: PMC3413785.
2.”Minimally Invasive and Small Incision Joint Replacement Surgery: What Patients Should Consider.” The Knee Society. PDF. ©2005, last reviewed January 2008. Accessed September 17, 2012. www.kneesociety.org.
3.T. Karachalios, D. Giotikas, N. Roidis, L. Poultsides, K. Bargiotas, and K. N. Malizos, “Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomized clinical and radiological trial,” Journal of Bone and Joint Surgery B, vol. 90, no 5, pp 584-591, 2008.
4.Khanna A, Gougoulias N, Longo UG, Maffulli N. Minimally invasive total knee arthroplasty: a systematic review. Orthop Clin North Am. 2009 Oct;40(4):479-89, viii. Review. PubMed PMID: 19773053.
5.Peter M. Bonutti, Michael G. Zywiel, Slif D. Ulrich, D. Alex Stroh, Thorsten M. Seyler, Michael A. Mont; A Comparison of Subvastus and Midvastus Approaches in Minimally Invasive Total Knee Arthroplasty. The Journal of Bone & Joint Surgery. 2010 Mar;92(3):575-582. doi: 10.2106/JBJS.I.00268
6.”Evidence report: minimally invasive surgery for total knee replacement.” ECRI Institute, Health Technology Assessment Information Service. April 2011. Accessed September 24, 2012. www.ecri.org.
7.Katz JN, Barrett J, Mahomed NN, Baron JA, Wright RJ, Losina E. Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Joint Surg Am. 2004 Sep;86-A(9):1909-16. PubMed PMID: 15342752.