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Archive Hot Technology 2020

The Future of Robotic-Assisted Total Joints

Improved precision, speedier recoveries and patient appeal are just a few of the reasons the robot is becoming a mainstay in orthopedics.

John Berry, Editorial Assistant

BIO

ON TARGET
Paul Miller, MD
ON TARGET Robotic-assisted surgery has the potential to eliminate outlier outcomes and level the playing field among joint replacement surgeons.

Forward-thinking facilities are embracing a high-tech approach to hip and knee replacements by outfitting their ORs with robotic platforms. Can you blame them? A growing body of evidence suggests robotic-assisted joint replacement results in more precise surgeries with fewer complications, allowing patients to ambulate sooner than they would after manual operations. There are also less proven, but very real, indirect benefits to adding ortho robots. Facilities that have already invested in the technology realize patients will come from near and far to have their joints replaced by surgeons who operate with the help of robotic assistance.

Unmatched accuracy

Precision is paramount during total hip or total knee replacements. Even the most skilled surgeons can't compete with the accuracy of bone cuts made during robotic-assisted surgery.

"It makes what we do more precise," says Cedric J. Ortiguera, MD, orthopedic surgeon at Mayo Clinic in Jacksonville, Fla. "All surgeons have outliers, a small percentage of procedures where we aim for certain targets that we end up missing. The use of robotics reduces the number of outliers and makes surgery a lot more exact."

Getting the cuts and implant placement just right can make or break the success of a procedure. Being mere millimeters off-target in the implant's alignment can reduce the overall lifespan of the hardware and could lead to the need for revision surgery. And if the implant winds up outside a certain range of ideal placement, the risk of implant failure is significantly increased.

Robotics takes surgery out of the realm of art and into the realm of science.
— Paul Miller, MD

Robotics has consistently shown to have a positive impact on both the success rate of procedures and recovery times of patients. "For a hip, the advantages are cuff position, leg length and offset, which is how much tension the muscles are under," says K. Seth Kuwik, MD, an orthopedic surgeon at the Orthopaedic Surgery Center in Youngstown, Ohio, who has performed approximately 500 robotic cases since 2015. "For a total knee replacement, it's about getting a balanced joint, having a knee with neutral alignment and flexion, and extension gaps that are equal."

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