Robotics is transforming the way joint replacement surgeries are performed. Robotic systems provide the surgeon with improved visualization of the joint and greater maneuverability of specialized instruments through very small incisions. This allows implant placement with great precision while minimizing damage to surrounding structures and thus speeding up recovery from surgery.
Robotic systems can be broadly divided into 3 types:
- Passive Robotic Systems: They are basically navigational systems. Their main function is to provide 3D visualization of joint anatomy. These robotic systems help the surgeon with preoperative planning, simulation of surgery, and intraoperative guidance. They also provide feedback regarding accuracy of bone cuts and joint biomechanics. Passive robotic systems do not actively participate in the surgery.
- Haptic Robotic Systems: They are also known as synergistic robotic systems. These systems combine the skill of the surgeon along with the improved dexterity and stability of the robotic arm. CT scanning is used to create an accurate 3D model of the patient’s joint anatomy. The surgeon then plans all aspects of the surgery including the types and sizes of the various components that will be used. The robotic arm is oriented precisely based on predetermined reference points. The robotic system assists the surgeon by making suggestions and providing assistance in the cutting zones, but the surgeon retains complete control over the robot. During the surgery, the surgeon makes use of computer navigation that provides real-time visual, auditory, and tactile feedback to guide the robotic arm in placement of the implant with a very high degree of precision and accuracy.
- Active Robotic Systems: Preoperative CT scans are taken which help the surgeon formulate a very precise surgical plan. The surgical plan is fed into a computer which controls the movements of the robotic arm during the surgery. The surgery is performed by the robotic arm under the watchful eye of the surgeon. The surgeon can stop the surgery at any time if necessary.
By accurately and reliably controlling variables such as alignment of the implant, soft tissue balance, and fixation methods, the margin for error during joint replacement surgery is greatly reduced thus helping to improve the outcomes in terms of function and longevity of the replaced joint.
