Mr James Gibbs
Consultant Orthopaedic Surgeon, Nuffield Health, Haywards Heath
(Specialist interest in hip & knee conditions)
Mr Paul Gibb
Consultant Orthopaedic Surgeon, The Knee Clinic, Tunbridge Wells
Robotic-assisted technology is enabling surgeons conducting knee replacements to work with greater accuracy than traditional surgery1,2,3 and facilitates a rapid recovery.4,5,6
More than 100,000 knee replacements are completed in England and Wales every year and an increasing number are done so with the help of robotic technology.
“This is not about more surgery with less experienced people. This is peace of mind for patients and surgeons. Using the CORI™ System, a total knee arthroplasty (TKA) study found surgeons can precisely plan and execute TKA procedures with reproducible accuracy within 0.5mm and 0.5 degrees in all three planes7-13,” confirms James Gibbs, who has been using a robotic-assisted system developed by medical tech leaders Smith+Nephew for the past two years.
Paul Gibb explains: “For patients, surgery enhanced by handheld robotics changes little apart from the outcomes. When they enter the theatre, flat markers are placed on a patient’s leg and a surgeon will create a patient-specific 3D virtual model using a smart mapping feature that eliminates the need for CT scan or x-rays.”
Surgeons then develop a real-time plan inside the theatre using the software to optimise implant position, alignment and balance the knee through range of motion (ROM).14
Improved patient outcomes
As James Gibbs points out: “While knee replacement surgery already has a high degree of success, we all know someone who has had a suboptimal experience.” Robotic-assisted technology aims to address this.
While it’s too early to say whether robotic technology can help to extend the lifetime of an artificial joint, Paul Gibb feels that: “The initial findings are encouraging and reports that physiotherapists are telling us patients are more mobile and patients are telling us they are recovering faster.”
Future surgical enhancements
Robotic-assisted technology is already helping implant companies to rethink the implant model and offer patients more bespoke options. “It means we can use precision milling instead of saws and remove less bone, so it’s less damaging for the patient. It feels like we’re only scratching the surface of what robotic technology has to offer the healthcare sector” says James Gibbs.
[1] Batailler C, White N, Ranaldi FP, et al. Knee Surg Sports Traumatol Arthrosc. 2019;27:1232.
[2] Herry Y BC, Lording T, Servien E, Neyret P, Lustig S. Int Orthop. 2017;41:2265-2271.
[3] Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. 77 cases compared with a matched control group. Eur. J. Orthop Surg Traumatol. 2020;30(4):723-9
[4] Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Arch Orthop Trauma Surg. 2018;138:1765-1771.3.
[5] Shearman AD, Sephton BM, Wilson J, Nathwani DK. Arch Orthop Trauma Surg. 2021; 021;141:2147– 2153 4.
[6] Sephton BM, Shearman A, Nathwani D. Poster presented at: European Knee Society Arthroplasty Conference;2-3 May, 2019; Valencia, Spain
[7] Smith+Nephew 2020. CORI◊ and NAVIO◊ Technical Specification Comparison. Internal Report. ER0488 REV B.
[8] Gregori A, Picard F, Lonner JH, Smith JR, Jaramaz B. 15th Annual Meeting;2015; Vancover, Canada.
[9] Gregori A, Picard F, Bellemans J, Smith JR, Simone A. Poster presented at: 15th EFORT Congress;4-6 June, 2014; London, UK.
[10] Bollars P, Boeckxstaens A, Mievis J, Janssen D. Poster presented at: 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery2019; New York, USA.
[11] Kopjar B, Schwarzkopf R, Chow J, et al. Poster presented at: ISTA 2-5 October, 2019; Toronto, Canada.
[12] Geller JA, Rossington A, Mitra R, Jaramaz B, Khare R, Netravali NA. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.
[13] Kaper BP, Villa A. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.
[14] Smith+Nephew 2020. CORI◊ and NAVIO◊ Technical Specification Comparison. Internal Report. ER0488 REV B.
The references 4-5 provided here are only applicable to UKA.
