EC Orthopaedics

Review Article Volume 14 Issue 2 - 2023

Robotic Surgery in Total Knee Replacement Surgery: Current Scenario and Future Perspective

Hatim M AlShareef1*, Abdulrahman M AlShamrani1, Abdulaziz M AlShamrani2 and Ibrahim A AlKhodair3

1Orthopedic Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
2Medical Student, Faculty of Medicine, King Abdulaziz University, Saudi Arabia
3Health Administration, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
*Corresponding Author: Hatim M AlShareef, Orthopedic Department, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Received: January 05, 2023;Published: January 20, 2023



Total knee arthroplasty (TKA) is an extremely promising procedure which re-establishes patient functionality and quality of life. Robotic arm assisted arthroplasty is gaining immense popularity in the field of Artificial Intelligence. This makes use of various technologies which is minimally invasive; wherein the robotic arm is promptly controlled by navigation technology. It also helps to fulfil a detailed preoperative plan, accurate implant selection, proper surgical sectioning of bone, and exact replacement of the artificial joint. These man-made joints portray high stability and accuracy. Substantiation of the use of robotics will improve the survival rate of the implant, functionality, and also the outcome which slowly gets accumulated as reported by the patient, nevertheless this has not been evidently verified until now. The application of Robotic TKA in present healthcare scenario has many limitations; firstly it is not budget-friendly and also leaves the patient with unnecessary exposure to radiation. The surgical efficiency is also compromised due to limited number of implant designs resulting in compatibility issues. The objective of this paper is to provide a neutral analysis of the available evidence or information regarding robotic technology for TKA.

 

Keywords: Total Knee Arthroplasty (TKA); Artificial Intelligence; Robotic Surgery

  1. Kayani B., et al. “Robotic technology in total knee arthroplasty: a systematic review”. EFORT Open Reviews 10 (2019): 611-617.
  2. Chen X., et al. “Robotic arm-assisted arthroplasty: The latest developments”. Chinese Journal of Traumatology 3 (2022): 125-131.
  3. Scott CEH., et al. “Activity levels and return to work following total knee arthroplasty in patients under 65 years of age”. The Bone and Joint Journal 99-B (2017): 1037-1046.
  4. Luna IE., et al. “Early patient-reported outcomes versus objective function after total hip and knee arthroplasty: a prospective cohort study”. The Bone and Joint Journal 99-B (2017): 1167-1175.
  5. Pinsornsak P., et al. “Multimodal infiltration of local anaesthetic in total knee arthroplasty; is posterior capsular infiltration worth the risk? A prospective, double-blind, randomised controlled trial”. The Bone and Joint Journal 99-B (2017): 483-488.
  6. O gonda L., et al. “Aspirin for thromboprophylaxis after primary lower limb arthroplasty: early thromboembolic events and 90 day mortality in 11,459 patients”. The Bone and Joint Journal 98-B (2016): 341-348.
  7. Lee GC. “Patient-specific cutting blocks: of unproven value”. The Bone and Joint Journal 98-B (2016): 78-80.
  8. Chen JY., et al. “The influence of body mass index on functional outcome and quality of life after total knee arthroplasty”. The Bone and Joint Journal 98-B (2016): 780-785.
  9. Ahmed I., et al. “Total knee arthroplasty with an oxidised zirconium femoral component: ten-year survivorship analysis”. The Bone and Joint Journal 98-B (2016): 58-64.
  10. Devers BN., et al. “Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty?” Journal of Arthroplasty 26 (2011): 178-186.
  11. Chawla H., et al. “Cost effectiveness of patellofemoral versus total knee arthroplasty in younger patients”. The Bone and Joint Journal 99-B (2017): 1028-1036.
  12. Abdel MP., et al. “Contemporary failure aetiologies of the primary, posterior-stabilised total knee arthroplasty”. The Bone and Joint Journal 99-B (2017): 647-652.
  13. Kutzner I., et al. “Mediolateral force distribution at the knee joint shifts across activities and is driven by tibiofemoral alignment”. The Bone and Joint Journal 99-B (2017): 779-787.
  14. Haddad FS. “Evolving techniques: the need for better technology”. The Bone and Joint Journal 99-B (2017): 145-146.
  15. Vince K. “Mid-flexion instability after total knee arthroplasty: woolly thinking or a real concern?” The Bone and Joint Journal 98-B.1 (2016): 84-88.
  16. Boonen B., et al. “No difference in clinical outcome between patient-matched positioning guides and conventional instrumented total knee arthroplasty two years post-operatively: a multicentre, double-blind, randomised controlled trial”. The Bone and Joint Journal 98-B (2016): 939-944.
  17. Scott CE., et al. “Predicting dissatisfaction following total knee arthroplasty in patients under 55 years of age”. The Bone and Joint Journal 98-B (2016): 1625-1634.
  18. Jones GG., et al. “Gait comparison of unicompartmental and total knee arthroplasties with healthy controls”. The Bone and Joint Journal 98-B (2016): 16-21.
  19. Huijbregts HJ., et al. “Component alignment and clinical outcome following total knee arthroplasty: a randomised controlled trial comparing an intramedullary alignment system with patient-specific instrumentation”. The Bone and Joint Journal 98-B (2016): 1043-1049.
  20. Karachalios T., et al. “An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty: pivot knee arthroplasty”. The Bone and Joint Journal 98-B (2016): 1050-1055.
  21. Van Der Woude JA., et al. “Knee joint distraction compared with total knee arthroplasty: a randomised controlled trial”. The Bone and Joint Journal 99-B (2017): 51-58.
  22. Mooney LT., et al. “The effect of the native kinematics of the knee on the outcome following total knee arthroplasty”. The Bone and Joint Journal 98-B (2016): 1471-1478.
  23. Khan M., et al. “The epidemiology of failure in total knee arthroplasty: avoiding your next revision”. The Bone and Joint Journal 98-B (2016): 105-112.
  24. Basselot F., et al. “Are ligament-tensioning devices interchangeable? A study of femoral rotation”. Orthopaedics and Traumatology: Surgery and Research 102 (2016): S213-S219.
  25. Teter KE., et al. “Accuracy of intramedullary versus extramedullary tibial alignment cutting systems in total knee arthroplasty”. Clinical Orthopaedics and Related Research 321 (1995): 106-110.
  26. Tayton ER., et al. “The impact of patient and surgical factors on the rate of infection after primary total knee arthroplasty: an analysis of 64,566 joints from the New Zealand Joint Registry”. The Bone and Joint Journal 98-B (2016): 334-340.
  27. Petrie JR and Haidukewych GJ. “Instability in total knee arthroplasty: assessment and solutions”. The Bone and Joint Journal 98-B (2016): 116-119.
  28. Allen MM and Pagnano MW. “Neutral mechanical alignment: is it necessary?” The Bone and Joint Journal 98-B (2016): 81-83.
  29. Huang T., et al. “Meta-analysis of gap balancing versus measured resection techniques in total knee arthroplasty”. The Bone and Joint Journal 99-B (2017): 151-158.
  30. Dalury DF. “Cementless total knee arthroplasty: current concepts review”. The Bone and Joint Journal 98-B (2016): 867-873.
  31. Mullaji AB and Shetty GM. “Correcting deformity in total knee arthroplasty: techniques to avoid the release of collateral ligaments in severely deformed knees”. The Bone and Joint Journal 98-B (2016): 101-104.
  32. Park SE and Lee CT. “Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty”. Journal of Arthroplasty 22 (2007): 1054-1059.
  33. Chin BZ., et al. “Robot-assisted versus conventional total and unicompartmental knee arthroplasty: a meta-analysis of radiological and functional outcomes”. Journal of Knee Surgery (2020).
  34. Kayani B., et al. “An assessment of early functional rehabilitation and hospital discharge in conventional versus robotic-arm assisted unicompartmental knee arthroplasty: a prospective cohort study”. The Bone and Joint Journal 101-B (2019): 24e33.
  35. Doan GW., et al. “Image-Free Robotic-Assisted Total Knee Arthroplasty Improves Implant Alignment Accuracy: A Cadaveric Study”. Journal of Arthroplasty 4 (2022): 795-801.
  36. Kayani B., et al. “Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study”. The Bone and Joint Journal 100-B (2018): 930e937.
  37. Marchand RC., et al. “Coronal correction for severe deformity using robotic-assisted total knee arthroplasty”. Journal of Knee Surgery 31 (2018): 2e5.
  38. Citak M., et al. “Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique?” Knee 20 (2013): 268e271.
  39. Moon YW., et al. “Comparison of robot-assisted and conventional total knee arthroplasty: a controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment”. Computer Assisted Surgery 17 (2012): 86e95.
  40. Song EK., et al. “Simultaneous bilateral total knee arthroplasty with robotic and conventional techniques: a prospective, randomized study”. Knee Surgery, Sports Traumatology, Arthroscopy 19 (2011): 1069e1076.
  41. Siebert W., et al. “Technique and first clinical results of robot assisted total knee replacement”. Knee 9 (2002): 173e180.
  42. Sultan AA., et al. “Utilization of robotic-arm assisted total knee arthroplasty for soft tissue protection”. Expert Review of Medical Devices 14 (2017): 925e927.
  43. Marchand RC., et al. “Patient satisfaction outcomes after robotic arm-assisted total knee arthroplasty: a short-term evaluation”. Journal of Knee Surgery 30 (2017): 849e853.
  44. Liow MHL., et al. “Robotic-assisted total knee arthroplasty may lead to improvement in quality-of-life measures: a 2-year follow-up of a prospective randomized trial”. Knee Surgery, Sports Traumatology, Arthroscopy 25 (2017): 2942e2951.
  45. Kim KI., et al. “Robot-assisted total knee arthroplasty in haemophilic arthropathy”. Haemophilia 22 (2016): 446e452.
  46. Kayani B., et al. “Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical. workflow but no learning curve effect for accuracy of implant positioning”. Knee Surgery, Sports Traumatology, Arthroscopy 27 (2019): 1132-1141.
  47. Sodhi N., et al. “The learning curve associated with robotic total knee arthroplasty”. Journal of Knee Surgery 31 (2018): 17-21.
  48. Gregori A., et al. “The learning curve of a novel handheld robotic system for unicompartmental knee arthroplasty”. In: The 14th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, Milan, Italy (2014).

Hatim M AlShareef., et al. “Robotic Surgery in Total Knee Replacement Surgery: Current Scenario and Future Perspective”. EC Orthopaedics 14.2 (2023): 27-36.