Three of our surgeons have now visited the Smith and Nephew Expert Connect Centre in Watford in order to be trained on the new NAVIO robotic system for use in total and partial knee replacements.
Robot Assisted Knee Replacement: What’s all the fuss about?
Traditional knee replacement surgery is extremely successful, and has given consistent results for more than 30 years. Satisfaction rates in excess of 85% are obtained across the country, making TKR one of the best operations in terms of patient quality of life improvement.
There is no doubt that the most important factors determining patient outcomes after surgery is initial patient selection and surgical choice ie doing the correct operation, at the optimal time for the patients who will gain most benefit.
The next most important factor is Surgeon choice ie making sure that your surgeon is skilled in carrying out the procedures that they offer.
The final factor regarding outcomes in total knee replacement surgery is implant choice and positioning. We have traditionally aligned and set the position of the implants using special ‘cutting jigs’, which although fairly accurate, do not allow us to put the implants exactly where they are designed to go, which can vary slightly from patient to patient.
Potential Benefits of Robot-Assisted Knee Replacement
Some medical research indicates that outcomes after knee joint replacement are better when surgeons use robotic technology.
The primary reason for the improved outcomes involves the precision with which the surgeon can position and align the implants. Improper alignment can result in soft tissue imbalance, and can also cause excess component wear, which may cause the implant to loosen prematurely. Patients may also experience problems with other components of the knee joint (such as knee cap tracking) that would not otherwise occur if the implant was aligned more precisely.
Nev D, Ed T and Shawn T trialling the NAVIO robot on model bones
Given the novelty of the technology however, there are as yet no large trials which show conclusive benefit of Robot assisted knee replacement over traditional techniques, and we also do not know if there are any hidden complications which may occur as a result of using the technology, for example: longer surgical times leading to increased risk of infection and/or blood clots.
Robotic assisted knee replacement surgery is still in its infancy, but there is no doubt that this technology is here to stay, and will improve dramatically over the next few years. If you are keen to find out more about this type of technology please do not hesitate to contact one of our surgeons, or follow one of the following links:
Robotics in Arthroplasty: A Comprehensive Review.
Jacofsky DJ, Allen M.
J Arthroplasty. 2016 Oct;31(10):2353-63
Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up.
Pearle AD, List JP, Lee van der L, Coon TM, Borus TA, Roche MW.
Knee. 419-4282017 Mar;24(2);419-428
Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis.
van der List JP, Chawla H, Joskowicz L, Pearle AD.
Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3482-3495.