Knee arthroplasty using a robotic system

The application of total joint replacement in the treatment of chronic degenerative knee diseases already brings 55 years of experience. During this long period, the collaboration between orthopaedic surgeons and engineers has led to the development of various prostheses and prosthetic materials that have been used from time to time.

Although knee joint replacement surgery is now considered safe and thousands of such procedures are performed every year throughout Greece, it is still in constant development. The parallel evolution of design and material technology has resulted in the continuous improvement of prostheses. The harmonization of the geometry of the prostheses with that of the joint, and the ability to assemble and "lock" the materials together, achieve improved knee kinematics, greater range of motion, less wear and minimize pain.

A major development in the field of arthroplasty are specific robotic systems, the use of which maximizes the accuracy of the operation, combining navigation with the use of a robotic arm. The surgical robot is used in order to plan the surgical procedure, measure the structures, select the correct size of the prosthesis and confirm its correct placement. All of this, in fact, without the need for CT scans or other additional X-rays.

It is a personalised process, with the aim of achieving the ideal solution for each patient. The robotic system measures and proposes, and the surgeon, having the possibility to modify, within certain limits, the proposal of the computer system, makes the required incisions with millimetre precision, selects the appropriate prosthesis and places it in the ideal place.

Thus, the surgeon can even determine whether the patient needs a total or partial arthroplasty and decide whether or not to preserve the ligaments of the cruciate ligaments. The big difference of this particular robotic system is that, throughout the application, the normal position of the knee joint is also measured, as the specificities of the ligaments and soft tissues of each patient are taken into account.

The surgical instruments are controlled by the robot, but the robot is controlled and used by the surgeon. In this way, the knee is cleaned and shaped with millimetre precision, as cartilage and bone are removed only where necessary. In addition, should the incisions move outside the predefined limits, the machine stops, dramatically increasing the precision of the operation.

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