Robotic-Assisted Total Knee Arthroplasty

Excerpt

Conventional total knee arthroplasty(TKA) is one of the safest and cost-effective procedures performed in orthopedics. With a patient satisfaction rate measured within the range of 75% to 92%, TKA presents a powerful method for pain relief and functional restoration in patients with advanced arthritis when exhausting all of the non-operative options. As technology and surgical procedures develop, surgeons try to improve patient outcomes and satisfaction. Robots present a tool in which surgeons can do surgical procedures while minimizing human error and maximizing operative accuracy. The term ‘robot’ begins from the Czech word ‘robota,’ which means forced labor or activity. In 1920, Karel Capek, the Czech play writer, wrote a science fiction play called " Rossum's Universal Robots," where Robots were a series of factory-manufactured artificial people that undertook ordinary tasks for their human masters. The play premiered on the 25th of January 1921, and that is when the word "robot" was introduced to the English language and to science fiction as a whole. The first robot surgery ever was performed in 1988 to perform neurosurgical biopsies. Since then, the applicability of robotics in surgery has progressed remarkably. Besides the rapidly increasing needs for TKA in the past years, robotic total knee arthroplasty (TKA) has increased in number considerably. Due to increasing average ages, populations encounter a much higher rate of osteoarthritis, so they need a greater amount of TKA.

The first surgical specialty to use robots was neurosurgery. In 1988, the first robotic surgery was recorded for performing neurosurgical biopsies. Followed by urosurgery, in 1991, for performing prostatic transurethral resection. Both specialties reported improved perfection and decreased the incidence of iatrogenic complications using robotic surgery. After that, the widespread use of robots in various surgical specialties with the advantages of smaller operative incisions, increased precision in soft tissue management, postoperative quicker recovery and return to work, and decreased length of hospital stay.

In orthopedics, a robotic TKR is designed to decrease the mistakes associated with bone cuts and prosthesis position and alignment. Robotic TKR has better surgical and clinical patient outcomes than conventional TKR. The first robotic-assisted TKA was performed in 1988 in the United Kingdom.