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Bones and joints

Robotics: making knee surgery more accurate and cost effective

knee painful surgery recovery
knee painful surgery recovery

Mr Simon Jennings

Deputy Clinical Director, Orthopaedics, Lead for Orthopaedic Enhanced Recovery, London North West Hospitals NHS Trust

Robotic-assisted surgeries are to become commonplace. The technology maximises the accuracy for surgeons and knee replacements patients should see faster recovery times.

Robot-assisted surgery may seem futuristic, but it’s already making a huge difference for total knee replacements and is proving to be something of a hit among specialists.

The technology works by first enabling the surgeon to build – in real-time – a three-dimensional image of the knee via sensors attached to the the thigh and shin bones. Surgeons are able to build an accurate blueprint of the knee and the leg’s alignment, as well as plan their course of action.

“On the computer, during the operation, I create a patient-specific plan. I’ve mapped out the knee, I’ve worked out what sizes of implants I need. I position them on the model to work out the perfect positon and shape to restore the patient’s anatomy and functional range of movement,” Mr Jennings says.

The robotic hand-piece improves accuracy

“The clever more robotic part, is the handpiece that I use to precisely cut the bones. It is a computer-controlled high-speed burr that cuts exactly and only where I have planned on the knee model I create.”

The level of accuracy for surgeons is what sets this technology apart from the older, more ‘analogue’ techniques. That accuracy allows surgeons to replicate exactly what they’ve planned, which simply wasn’t as accurately achievable when using the naked eye.

Faster recovery time for total knee replacement patients

Mr Jennings thinks that improving the accuracy of implant placement is likely to have a hugely positive knock-on effect for patients and the NHS.

“Patients actually get up and out a bit quicker, and the knee should feel normal a bit quicker,” he says. 

“The robotic system will limit your cutting to just what you need to cut, and fine-tune it to a greater degree of accuracy. It is a huge leap forward.”

This new method could be presumed to be more expensive than the traditional forms of surgery. In fact, Mr Jennings believes the practice will prove more cost-effective for patients and the NHS in the long-term.

Previously, trays upon trays of instruments would be wheeled in to surgery in order to fit all shapes and sizes of knee.

“We just don’t have to do that anymore. I can work out exactly what size I want to use, saving the costs of steralising unrequired instruments.”

The improved accuracy of implant placement will further improve the longevity of implants, too. By ensuring they are placed correctly and in a balanced fashion, they’ll be less likely to wear.

“It definitely gives me a degree of precision we never previously had,” Mr Jennings said.

We are looking closely at our patients to show how the whole package of the total knee replacement process can be improved. From patient experience in the clinic and in-patient admission, to the post-surgery outcome, satisfaction and longevity.

“It’s early days, but the initial signs are incredibly positive.”

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