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Speaker: Value of robotic-assisted TKA is its accuracy, safety
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LAS VEGAS — Robotic approaches for total knee arthroplasty have advantages over manual methods, and research has shown use of this technology is associated with greater patient satisfaction and better WOMAC outcomes, according to a presenter.
Michael A. Mont, MD, who discussed options for robotic-assisted TKA during a symposium at the American Academy of Orthopaedic Surgeons Annual Meeting, said, “Almost all the registries show at least 20% of the patients are dissatisfied. So, we think the robots may be a solution.”
Newer robotic systems are imaging-based and many use trackers that are applied in the OR. These systems use CT or MRI to develop an operative plan for a patient’s knee replacement, which provides information about size of components needed, rotation and alignment, according to Mont.
“But, it’s not exact. This is still a soft tissue procedure. You have to adjust this plan in the OR” based both on the soft tissues and the patient’s flexion/extension, he said.
A virtual prosthesis is then placed and, once the gaps are balanced, its position can be adjusted, and the robot can be enlisted to make the cuts.
“I think this robotic cutting is precise. I can tell that, to me, it’s more precise and accurate than using manual techniques,” Mont said, noting the robot safely cuts around the PCL during cases in which a PCL-retaining prosthesis is used.
“Your chance of cutting the PCL is close to zero,” he said.
Studies about robotic TKA, such as a recent one by Hampp and colleagues that Mont discussed, showed that compared to manual techniques, the robot’s accuracy and precision in making bone cuts and doing the alignment was more than three-times more accurate and precise.
In a study by Marchand, Mont and colleagues, 6-month WOMAC total and WOMAC pain scores were significantly better vs. patients whose surgery was not performed with a robot, he said.
“I think robots are the wave of the future. First of all, they are a great teaching tool, and we did not even talk about it. As an education tool, they can’t be beat,” Mont said. “For clinicians out in the audience here, it achieves greater accuracy and precision. [The] soft tissue protection is there. [The] improved radiographic outcomes, a shortened learning curve [and] high patient satisfaction helps us personally, and I think it can reduce costs with this type of technology.” – by Susan M. Rapp
Reference s :
Hampp EL, et al. J Knee Surg. 2019;doi:10.1055/s-0038-1641729.
Marchand RC, et al. J Knee Surg. 2017;doi:10.1055/s-0037-1607450.
Mont MA. Symposium K: Options for robotic-assisted TKA. Presented at: American Academy of Orthopaedic Surgeons; March 12-16, 2019; Las Vegas.
Disclosure: Mont reports he is a paid consultant for Cymedica, a paid consultant for and receives research support from DJ Orthopaedics, is a paid consultant for Flexion Therapeutics, is a paid consultant for and receives research support from Johnson & Johnson, receives publishing royalties and financial or material support from Medicus Works LLC, receives IP royalties from Microport, receives research support from NIH, is a paid consultant for and receives research support from Ongoing Care Solutions, is a paid consultant for and receives research support from OrthoSensor, is a paid consultant for Pacira, is a paid consultant for and receives stock/stock option from PeerWell, is a paid consultant for Performance Dynamics, is a paid consultant for Pfizer, is a paid consultant for Skye Biologics, is a paid consultant for and receives IP royalties and research support from Stryker, is a paid consultant for Tissue Gene, receives research support from TissueGene and receives stock/stock options from USMI.