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Would you let a robot operate your knee?

Robotic knee surgery is currently known as robot-assisted knee surgery or computer-assisted knee surgery. It is a relatively new advancement in the field of orthopedics. It involves the use of robotic technology to assist surgeons in performing knee surgeries with a high level of precision and accuracy. I perform robotic knee surgery regularly and am privileged to be exposed to various systems through my work at our academic hospital. Here are some pros and cons associated with robotic knee surgery:





Advantages of Robotic Knee Surgery:


Enhanced Precision: Robotic systems provide a higher level of accuracy and precision compared to traditional surgical techniques. They allow surgeons to plan and execute procedures with a greater degree of control, leading to improved surgical outcomes. This hasn't translated yet to massive improvements in outcomes but it gives us very important information to continue to improve our skills, challenge our current ways of operating and lays foundation for important innovations.


Customized Approach: Robotic systems offer preoperative planning and 3D modeling capabilities, allowing surgeons to create personalized surgical plans based on the patient's unique anatomy. This can result in a more tailored approach and potentially better patient outcomes. But especially in patients with unique anatomy (i.e. due to a deformity) it helps tremendously with precision.


Smaller Incisions: Robotic knee surgery often involves smaller incisions compared to traditional open surgery. These smaller incisions but especially less soft tissue dissection can result in less tissue damage, reduced scarring, and a potentially faster recovery for patients.


Real-time Feedback: Robotic systems provide real-time feedback during surgery, allowing surgeons to make adjustments and ensure optimal implant positioning. This can help reduce the risk of errors and complications.


Rapid Recovery: Some studies suggest that robotic knee surgery may contribute to a quicker recovery time for patients. With smaller incisions and precise surgical techniques, patients may experience less postoperative pain, reduced hospital stays, and faster return to daily activities.



Disadvantages of Robotic Knee Surgery:


Cost and Time: Robotic knee surgery can be more expensive compared to traditional knee surgery methods. The equipment and technology required for robot-assisted procedures may increase the overall cost of the surgery, potentially limiting accessibility for some patients. Often these some of these costs are also transferred directly onto the patient. Also, setting up the robot adds some time to surgery, even in the most experienced robotic surgeon, as the system has to be set up and calibrated, but also all information received needs to be processed by the surgical team which leads to precision, but also time spent on this process.


Learning Curve: Adopting robotic systems requires specialized training for surgeons. There is a learning curve associated with becoming proficient in using the technology effectively. Surgeons need to gain experience to maximize the benefits of robotic assistance. It is therefore important to choose a surgeon with regular experience in robotic surgery for your knee replacement. Despite the robotic assistance, the success of the surgery still relies on the surgeon's skills and expertise. The benefits of robotic technology are best realized when combined with the proficiency of an experienced surgeon.


Potential Technical Issues: Robotic systems rely on complex technology, and like any technology, there is a possibility of technical malfunctions or system errors. While rare, such issues can impact surgical procedures and require troubleshooting.


Limited Applications: Robotic knee surgery is primarily utilized for specific procedures, such as partial knee replacements and some total knee replacements. It may not be suitable for all knee conditions or patients, limiting its broader application.


It's important to note that the pros and cons of robotic knee surgery may vary depending on individual patient factors, the specific robotic system being used, and the surgeon's experience. Patients considering robotic knee surgery should have a detailed discussion with their healthcare provider to understand the potential benefits and risks specific to their case.

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