Robotic Knee Replacement

Robotic Knee Replacement

Recent technological advancements have been mirrored in our prosthetic procedures; we can now do robot-assisted surgery with 98.9% accuracy. Excellent postoperative results in patients are attained with this accuracy, which is difficult for even the most skilled surgeon to achieve, and the prosthesis's survival duration is extended.

Currently, 2 types of robot-assisted arthroplasty are applied in our country and Navio is one of them. In Istanbul and Bursa, there are approximately 600 arthroplasty operations performed with robotic surgery so far. In this system, which will be applied by us for the first time in Izmir, we will be able to perform the operations with the help of the Navio Robotic system and a professional team from Bursa.

With the robotic system, knee prosthesis surgery can be performed by targeting only the part of the knee damaged by calcification and protecting the healthy tissues and ligaments surrounding that part (1). Thus, prosthesis surgery can be performed on the inner, outer and posterior kneecap joint compartments of the knee joint. The insertion of an artificial joint only on the inner or outer joint side is called unicompartmental knee replacement, while its application to two sites is called bicompartmental knee replacement.

With the Navio (2) robotic system, a 3D model of the knee joint is created in horizontal and vertical plans during surgery without the need for a preoperative CT scan. The implant size and the angles of the prosthesis placement and the fit of the prosthesis parts to each other are determined instantly and precisely.  Navio robotic arm helps the surgeon to place the implants in the most appropriate and balanced way by visualizing the soft tissue balance with numerical data. Thus, the patient is not exposed to radiation as no preoperative CT scan is required.

Using Navio's robot-assisted handpiece, the surgeon removes the damaged bone from the remaining healthy bone. This ensures a safe surgery for both the patient and the surgeon, without allowing even a millimeter of error. It is not possible to plan with such fine calculations in standard manual surgery.

While the knee replacement method performed under the control of the surgeon minimizes the margin of error, it also ensures that the postoperative recovery process is shorter, more painless and easier.

How to Perform Knee Replacement Surgery with Robotic Knee Surgery (1,2)

With the Navio robot, a 3D model is created in horizontal and vertical planes by collecting anatomical data of the knee during surgery, without the need for preoperative tomography. The model information provides real-time information that allows the most accurate positioning and alignment of the implant during surgery.

During surgery, the robotic arm guides the orthopedic surgeon in the correct preparation and placement of the implant socket, allowing the implant to be placed at the optimal angle and in the most stable manner.  While the surgeon performs the surgery, the robotic system prevents the surgeon from deviating from the plan and making mistakes.

Even an experienced orthopedic surgeon has some margin for error when manually adjusting implant positions. During surgery with the robotic system, the fit of the implants at all bending angles of the knee is evaluated kinematically. If necessary, real-time adjustments can also be made during surgery to ensure correct knee kinematics and soft tissue balance. Thus, it minimizes the margin of error by ensuring that the surgical procedure is achieved with extreme precision and high accuracy, specific to the patient's own anatomy. This also reduces the risk of unwanted complications (such as mechanical loosening and malposition) in the future.

Robotic knee surgery can provide patients with a more natural knee sensation, as only the damaged articular surface and bone structures are removed while all other knee ligaments are preserved. In addition, since healthy bones are preserved, patients who undergo robotic knee replacement surgery remain suitable candidates for total knee replacement in the future if necessary.

As a result of smaller incisions, minimal tissue trauma and maximum preservation of healthy bones in robotic knee replacement surgery, the patient can recover faster and more painlessly and return to daily life more quickly. Patients are usually able to walk the same day or the next day after surgery. Depending on the general health status of the patient, they are allowed to return to their normal daily activities after a few weeks.

All prosthetic implants have an expected lifespan, which varies depending on various factors such as the patient's body weight, activity level and pattern, the quality of their own bone structure and following their doctor's recommendations. In robotic surgery, the ability to calculate technical measurements with high accuracy and precision and to place the implant in the most ideal anatomical position specific to each patient contributes to prolonging the life of the prosthesis by causing less wear and loosening of the implant.

Advantages of Robotic Knee Replacement Surgery (1,2)

Use of highly advanced robotic technology,
- Detailed planning during surgery with a high-resolution, patient-specific imaging system,
- Precise prosthesis of only the damaged part of the knee,
- Implementation through a smaller surgical incision,
- Minimization of tissue trauma,
- Maintaining healthy bone stock,
- Protection of all ligaments in the knee,
- A more natural knee feel,
- Faster and more painless recovery,
- Quicker return to daily life,
- Prolonged prosthesis life due to the high accuracy of implant placement.