Joint replacement of the knee is one the most clinically successful and cost-effective procedures in medicine, with excellent long-term outcomes. The number of total knee replacement procedures is steadily increasing because of the aging population and the desire we all have of maintaining our mobility and quality of life. The length of time these implants last is becoming more important as the need for revision procedures increases as well.
Proper component alignment, rotational position and soft-tissue balancing are all critical factors in determining implant survival and clinical outcomes after knee replacement. Research has shown that, despite excellent outcomes we get with knee replacement, improper alignment is estimated to occur in as many as 30% of procedures using conventional instrumentation. This type of instrumentation currently uses guides that crudely use the patient’s bone and anatomy to determine how we resect bone and cartilage to align the leg.
Computer assisted knee replacement was developed in an attempt to improve the precision of component implantation and alignment in total knee replacement. With computer navigation, which began in the late 1990’s, the use of three dimensional sensors allows the surgeon to map the patient’s knee and obtain lower extremity alignment digitally and use that information to make appropriate bone resections to align the leg in precisely the correct way. Surgeons have seen this technology improve the accuracy of implant alignment in many studies. However, with computer navigation, errors can still occur at the time of making bone cuts leading to problems with alignment of the leg.
Robotic assisted surgery has more recently been developed to communicate this information to a computer and use intelligent software to execute the bone removal with tactile feedback from the surgeon. Most of the research on robotic assisted knee replacement has involved partial knee replacement where it has been shown to improve implant positioning and alignment. Partial knee replacement is well-suited for robotic surgery as it is technically challenging, minimally invasive, and requires the resection of only the diseased tissue with preservation of all other compartments. Limited studies regarding robotic assisted total knee replacement has been shown to improve alignment and more specifically implant rotation to a greater degree than conventional techniques.
Health care consumers have a choice when selecting providers for health care. Arthritis of the knee is a common condition that results in significant disability and decreased quality of life. Total knee replacement is a very common procedure that has a dramatic impact on patient mobility, however, the procedure is best done the right way the first time. These changes in techniques are our way of providing the best possible care to our patients.
McBride Orthopedic Hospital is proud to provide robotic assisted partial and total knee replacement to our patients. We are a leading institution providing NAVIO robotic assisted techniques and are one of the first hospitals in the United States to provide this technology. It is our sincere desire to provide the highest quality of care to the people of Oklahoma. If you are suffering from disabling knee pain and would like to discuss with us whether you are a candidate for this state of the art treatment, give us a call at 405-230-9270!
