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Archive Orthopedic Surgery 2017

Robotic Knee Replacement

Robotic arms help surgeons prepare the bone with sub-millimeter accuracy and place the implant with spot-on precision.

Dan O

Dan O'Connor, Editor-in-Chief

BIO

Cedric Ortiguera, MD ROBODOC Cedric Ortiguera, MD, performs robotic knee replacement surgery at the Mayo Clinic campus in Jacksonville, Fla.

The difference between a so-so and a spectacular knee replacement is often the slimmest of margins — 1 mm of shaved bone or 1 degree of implant placement — a bridge that a robotic arm can gap better than a surgeon's hands.

"We're good at putting the implant in and making it look good on an X-ray, but it doesn't feel right to a fair percentage of patients," says Cedric Ortiguera, MD, an orthopedic surgeon at the Mayo Clinic campus in Jacksonville, Fla.

It's estimated that 20% of joint replacement patients are less than thrilled with their newly replaced knee. Despite the perfect post-op X-ray, the restored range of motion and the vanquished pain, the artificial implant feels, well, artificial. It just doesn't feel normal — the patient can tell which knee was operated on.

"We're all after that 20%," says hip and knee replacement specialist Neil P. Sheth, MD, an assistant professor of orthopaedic surgery at Pennsylvania Hospital in Philadelphia, Pa. "Most hip replacement patients can't remember which hip they had done a year later. We're trying to get there with knees."

More and more surgeons like Dr. Ortiguera and Dr. Sheth are turning to a new partner to improve outcomes: a robotic arm that helps docs prepare the bone with sub-millimeter accuracy and place the implant with spot-on precision.

"Robotic technology adds a new level of accuracy and precision to how we insert the implants that's very difficult to reproduce with your hands," says Dr. Ortiguera. "Plus, we can balance the ligaments better so patients will feel better with the knee."

While the robot plays a vital role, it doesn't perform the surgery alone and it's not a substitute for a surgeon's skill. "I do the surgery, I'm holding an instrument. The robot guides my hand," says Dr. Ortiguera. "It won't make a bad surgeon a good surgeon, but it can help make a good surgeon better."

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