Robotic Knee Surgery

Recently, "robotic" knee systems have been available to perform partial knee replacements. These systems are not truly robotic, but provide a semiactive system that uses a computed tomography-based preoperative plan with intraoperative registration. The technology uses haptic (tactile feedback) constraints to try to convey a more precise method of preparing the bone for implant placement to the surgeon. More advanced systems are also becoming available —navigated freehand bone cutting (NFC)— that have the most potential to be useful in knee replacement surgery. This technology can use either preoperative three-dimensional imaging or computer navigation registration landmarks to aid surgeons in aligning implants. 

Overall, the role of robotics for total knee arthroplasties (TKAs) and UKAs remains uncertain as the longer operative time can lead to higher risk of complications.  Robotics have not demonstrated an ability to significantly improve component positioning compared to computer navigation, and no study has demonstrated improved functional outcomes at near-term or medium-term follow-up. In addition, concerns over higher infection rates and soft tissue damage may limit the uptake of this technology in the short term till it matures. At present Computer Assisted Surgery, where the surgeon uses a computerized system to monitor the prosthesis positioning offers the most mature arthroplasty positioning method. Not all new technology in knee surgery is beneficial. For example, Patient Specific Instruments,  that were introduced just a few years ago to much fanfare, actually result in worse outcomes for patients than conventional techniques .