Robotic surgery in Orthopedics

  • Introduction– Use of Robotic technology in Orthopedics had been initiated in 1992 by introducing ROBODOC, for the planning and performance of total hip replacement. Subsequently, Robotics got its place in varied orthopaedic subspecialties e.g. spine, total joint arthroplasty, trauma, shoulder, and foot & ankle. It has the potential for significant improvements in surgical planning, accuracy of component implantation and patient safety.
  • Classification– Robotic system in Orthopaedic surgery can be classified (based on direct & indirect action and mechanism of cutting) into:
    1. Autonomous
    2. Haptic– surgeon guided
    3. Boundary control
  • Advantages:
    • Advocates of robot-assisted systems describe better patient outcomes through improved pre-operative planning and enhanced execution of surgery
    • Improvement in implant placement, e.g., reducing outliers.
    • accessibility of certain anatomical areas
    • reduction of complications
    • decreased use of fluoroscopy
    • remote surgical intervention.
  • Disadvantages:
    • Increased cost
    • Limited availability
    • Lack of evidences regarding the efficiency and safety of such systems
    • Requirement of updated softwares
    • Prolonged learning curve for surgeon
    • Increased operative time
    • Requirement of imaging for preoperative templating
    • Risk of incorrect placement of implants & incorrect/poor input of data by surgeon
    • Possibility of no difference of long-term outcomes compared to non-robotic procedures.

Please refer to the following articles for further details: