Robotic orthopedic surgery is becoming more accessible and common. This article surveys the benefits and challenges of this innovation in 2023 so physicians can use it effectively in their practice.
Orthopedic surgeons now have robotic arms at their disposal. This exciting technology has the potential to give patients a better range of motion, along with quicker recovery after joint replacement surgery and other musculoskeletal system procedures.
Robotic orthopedic surgery has become more accessible over the last decade, and trends indicate it will keep expanding. Examine the current uses of orthopedic robotics, so you can get a glimpse of what’s to come and how you can harness this technology to improve patient outcomes.
Types of orthopedic robotic surgery
Some of the most common orthopedic procedures can be performed with the assistance of robotic technology. Whether it’s a joint replacement, bone alignment, or another type of musculoskeletal surgery, robotic arms have proven to be an exciting asset in the operating room.
In spine surgeries, robotics are typically used for pedicle screw placement, and studies show outcomes have been favorable. These positive outcomes include less exposure to radiation and less time spent in the hospital.
The same studies revealed the robotic method was more precise than freehand. In an overwhelming majority of cases included in the study, 96% of pedicle screws were placed within 1 millimeter of their desired orientation.
An exciting development in spinal robotic surgery news is Point Robotics MedTech Inc. receiving FDA clearance in summer 2022 for its Kinguide Robotic-Assisted Surgical System. Set to make its debut in the United States soon, the Kinguide uses image-guided navigation and handheld drilling, reducing surgeons’ burdens during spinal fusions.
Total knee replacements (TKA) or partial knee replacement surgeries can now be performed with computer-assisted robotic arms that guide instruments in surgery.
Robotic arms used in orthopedic knee surgery allow for improved precision — so precise that it can cut within “a fraction of a millimeter” in surgery. The robotic arms also provide resistance or stop altogether if the cut moves beyond pre-set boundaries — which means fewer errors in surgery.
The Mako robotic arm from leading medical tech company Stryker is used to help people dealing with pain from a knee injury or osteoarthritis and looking for total knee arthroplasty or partial knee replacements. Mako’s been linked to less pain post-surgery and equal or better function compared to traditional TKA.
Total hip replacements are one of the most successful orthopedic surgeries, made even more effective with robotics.
Medical device company Smith+Nephew was given the green light to use its CORI handheld robotic-assisted system for total hip arthroplasty (THA) in early 2022. Studies have shown that robotic surgery for THA reduced the risk of necessary revisions and improved patient satisfaction.
The smaller incisions via robotic arms in hip surgery also mean less damage to surrounding healthy tissue.
Studies have linked robotic surgery with improved accuracy in orthopedic implant placement, as well as better patient outcomes (less bleeding and pain post-op).
Robots can achieve a better bone-implant contact surface, resulting in reduced fixation time and improved stability of the implant. A robot is also able to cut complex freeform surfaces and isn’t limited to planar cuts, as opposed to traditional methods.
Benefits and challenges of robotic-assisted orthopedic surgery
In addition to the advancements already made, robotic technology is providing a series of impressive updates to the field of orthopedic surgery. But it remains to be seen if the benefits outweigh the challenges.
The cutting-edge technology of robotic orthopedic surgery has been linked to a number of benefits for surgeons and patients alike, including advanced surgical planning.
Robotic arms are more accurate than the human eye, resulting in less soft tissue damage and more precise implant positioning.
A common concern for professionals whenever new technology enters the scene pertains to time investment. A significant benefit of orthopedic robotic surgery is that surgeons can become efficient users of a robotic system with a “relatively short learning curve.”
Robotic surgery has also been shown to improve workflow and success rates, including less time spent in surgery.
Despite the benefits that come with robotic orthopedic surgery, there are still downsides to consider before full-scale adoption can take place.
Robotic surgery has become more accessible, but it remains an expensive solution. Only hospitals and surgical centers that can afford the technology are able to offer it to patients.
There’s also little to no evidence of improvement in long-term outcomes as of yet. That may change as more years pass, the technology advances, and studies extend to include patient outcomes over a longer period of time.
There’s also the chance of a robotic malfunction occurring during surgery. Thankfully, instances of this are rare, but it’s worth noting regardless.
3 examples of orthopedic robotics
Intuitive’s da Vinci surgical system provides capabilities that allow surgeons to improve aspects like their view of the surgical field as well as the precision of the cuts being made.
Let’s dive into three examples of how the da Vinci system is used in robotic orthopedic surgery.
A surgical console where the surgeon controls the whole procedure
It may look like the robot is performing surgery, but with the da Vinci system, the machine is working with the surgeon. The robotic arm is controlled by the surgeon from a console and, according to da Vinci, allows for better wrist dexterity than even the most skilled surgeon’s wrist can deliver.
Surgeons control the procedure from the console, where they essentially have a navigation system they can guide the robotic instruments from. The surgeon’s hand movements are translated in real-time, and the robotic arms provide a better range of motion. This system and similar robotic systems provide improved precision, which is ideal for minimally invasive surgery.
Surgical arms that hold specially made instruments
The da Vinci system has arms to guide special tools held and controlled by the robotic arm, including the Force Bipolar, which allows for better retraction and dissection.
Surgeons save time by changing the strength of the tool’s grasp with a simple tap of a foot pedal instead of having to stop and switch instruments altogether.
A special camera that allows a 3D view of the surgical area
The da Vinci system’s robotic camera provides enhanced 3DHD vision. It produces a true 3D color image the same way our eyes do. The surgeon seated at the console controls the robotic arm that positions the camera and lighting. The camera can be placed within a few inches of the surgical area, providing better dissection.
In addition to the 3D camera, there are two other cameras available for the da Vinci system. One is a 30-degree oblique, which allows the surgeon to “peek around the corners” during surgery.
From robotics to AI: The future of orthopedics is now
Knowing what technology is on the horizon — whether it’s robotic orthopedic surgery or another promising advancement — is the best way to prepare for the future in orthopedics and continuously deliver the best patient care.
Artificial Intelligence is another exciting example of emerging technology in the field of orthopedics. Learn more about how Exer Health works with surgeons to improve patient outcomes.
Photo by Possessed Photography