Written by Mr Arjuna Imbuldeniya for Doctify

Robots carrying out hip replacements sounds like something out of Blade Runner. However, don’t expect solo cyborg surgeries anytime soon. Here to explain more about the role robots now play in orthopaedic surgery is Mr Arjuna Imbuldeniya.

What are the benefits of using robots and computers in knee or hip replacement surgery?

Whilst traditional surgical instruments and tools have helped orthopaedic surgeons perform knee and hip replacement surgery to a high standard for many years now, computer technology and more recently robotics has developed over the last decade to help make these procedures more accurate and bespoke for each patient and their specific anatomy.

The benefits to the patients are that they can be certain the surgeon has the latest state of the art equipment at hand to plan their surgery before the procedure. They can also carry out that plan with precision, be able to make changes if necessary during surgery and use the technology to predict what effect those changes might have before he or she alters the plan. The main benefit is a happy patient with a hip or knee replacement that lasts longer due to its accurate sizing and placement within the patient.

Could you explain how a robot would assist during an operation?

Currently, the main orthopaedic robotic systems in use are semi active systems. This means they do not perform the operation autonomously but are under the surgeons control throughout the procedure. The robot makes a 3D model of the patient’s hip or knee either from a CT scan taken before the surgery or from bony points registered from the patient during surgery. The robot helps make a surgical plan for how much worn away arthritic bone to remove from the patient and the optimal position and alignment of these cuts to restore the patients normal and individual anatomy. The robotic arm has a metal tipped burr on the end of it that then resects the worn part of the joint under the surgeons control. Safety features mean the burr shuts down if the surgeon tries to cut any bone outside of the planned procedure.

What does using technology in surgery mean for recovery times?

A few recent studies have shown that recovery times are faster once the initial learning curve of using the technology has passed amongst surgeons who perform these procedures regularly. The surgery can be quicker, more precise and can be augmented with less invasive approaches to both the hip and knee. The use of the precise robotic arm means less tissue retraction is required, and often bony surgical cuts do not need to be repeated.

What do you think the future of orthopaedic surgery holds?

The future is incredibly exciting given the amount of technology we hold in our pockets with our smart phones, we are finally seeing a diffusion of this type of technology into our operating rooms. It is essential that we keep improving our surgical procedures and utilize technology and innovation to improve care for our patients. With stem cell therapy continuing to show promise for those suffering from hip and knee pain, I believe we will soon do less total joint replacement and more mini focal joint resurfacing and cartilage regeneration procedures going forward.

Are there aspects of surgery that can never be replaced by robots and computers?

I hope so otherwise I won’t have much work soon! Currently robots cannot make tailored or bespoke decisions with each patient taking into account their individual needs. They are also unable to autonomously deviate from plan A if things don’t go as planned during any stage of the surgery and currently lack the most important values of being a good surgeon and doctor which are empathy, compassion and kindness.

 


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