Robot-assisted joint arthroplasty—An emerging technology of the present and the future_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

FU Jun ^1,2,3 , NI Ming ^1,2,3 ,  CHEN Jiying ^1,2,3

1. Senior Department of Orthopedics, the Fourth Medical Centre of Chinese PLA General Hospital, Beijing, 100048, P.R.China;
2. National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Beijing, 100853, P.R.China;
3. Department of Orthopedics,the First Medical Centre of Chinese PLA General Hospital, Beijing, 100853, P.R.China;

Corresponding author：

CHEN Jiying, Email: chenjiying_301@163.com

Keywords：

Robot-assisted surgery; joint replacement; precision surgery; artificial intelligence

DOI：

10.7507/1002-1892.202106086

Video：

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Objective To review and evaluate the research progress of the robot-assisted joint arthroplasty.Methods The domestic and foreign related research literature on robot-assisted joint arthroplasty was extensively consulted. The advantages, disadvantages, effectiveness, and future prospects were mainly reviewed and summarized.Results The widely recognized advantages of robot-assisted joint arthroplasty are digital and intelligent preoperative planning, accurate intraoperative prosthesis implantation, and quantitative soft tissue balance, as well as good postoperative imaging prosthesis position and alignment. However, the advantages of effectiveness are still controversial. The main disadvantages of robot-assisted joint arthroplasty are the high price of the robot system, the prolonged operation time, and the increased radioactive damage of the imaging-dependent system.Conclusion Compared to traditional arthroplasty, robot-assisted joint arthroplasty can improve the accuracy of the prosthesis position and assist in the quantitative assessment of soft tissue tension, and the repeatability rate is high. In the future, further research is needed to evaluate the clinical function and survival rate of the prosthesis, as well as to optimize the robot system.

Citation： FU Jun, NI Ming, CHEN Jiying. Robot-assisted joint arthroplasty—An emerging technology of the present and the future. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(10): 1217-1220. doi: 10.7507/1002-1892.202106086 Copy

1.	裴国献. 数字骨科: 骨科领域的第三次技术浪潮. 中华创伤骨科杂志, 2019, 21(1): 3-5.
2.	Picard F, Deakin AH, Riches PE, et al. Computer assisted orthopaedic surgery: Past, present and future. Med Eng Phys, 2019, 72: 55-65.
3.	Radermacher K, Tingart M. Computer-assisted orthopedic surgery. Biomed Tech (Berl), 2012, 57(4): 207. doi: 10.1515/bmt-2012-0401.
4.	Jacofsky DJ, Allen M. Robotics in arthroplasty: A comprehensive review. J Arthroplasty, 2016, 31(10): 2353-2363.
5.	Batailler C, White N, Ranaldi FM, et al. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1232-1240.
6.	Agarwal N, To K, McDonnell S, et al. Clinical and radiological outcomes in robotic-assisted total knee arthroplasty: A systematic review and meta-analysis. J Arthroplasty, 2020, 35(11): 3393-3409.
7.	Manning W, Ghosh M, Wilson I, et al. Improved mediolateral load distribution without adverse laxity pattern in robot-assisted knee arthroplasty compared to a standard manual measured resection technique. Knee Surg Sports Traumatol Arthrosc, 2020, 28(9): 2835-2845.
8.	Gordon AC, Conditt MA, Verstraete MA. Achieving a balanced knee in robotic TKA. Sensors (Basel), 2021, 21(2): 535. doi: 10.3390/s21020535.
9.	Nodzo SR, Chang CC, Carroll KM, et al. Intraoperative placement of total hip arthroplasty components with robotic-arm assisted technology correlates with postoperative implant position: a CT-based study. Bone Joint J, 2018, 100-B(10): 1303-1309.
10.	Illgen RL, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: Outcomes at minimum two-year follow-up. Surg Technol Int, 2017, 30: 365-372.
11.	Domb BG, Redmond JM, Louis SS, et al. Accuracy of component positioning in 1980 total hip arthroplasties: A comparative analysis by surgical technique and mode of guidance. J Arthroplasty, 2015, 30(12): 2208-2218.
12.	Nawabi DH, Conditt MA, Ranawat AS, et al. Haptically guided robotic technology in total hip arthroplasty: a cadaveric investigation. Proc Inst Mech Eng H, 2013, 227(3): 302-309.
13.	Kayani B, Tahmassebi J, Ayuob A, et al. A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty. Bone Joint J, 2021, 103-B(1): 113-122.
14.	Kayani B, Konan S, Tahmassebi J, et al. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. Bone Joint J, 2018, 100-B(7): 930-937.
15.	Shaw JH, Lindsay-Rivera KG, Buckley PJ, et al. Minimal clinically important difference in robotic-assisted total knee arthroplasty versus standard manual total knee arthroplasty. J Arthroplasty, 2021, 36(7S): S233-S241.
16.	Kim YH, Yoon SH, Park JW. Does robotic-assisted TKA result in better outcome scores or long-term survivorship than conventional TKA? A randomized, controlled trial. Clin Orthop Relat Res, 2020, 478(2): 266-275.
17.	Jeon SW, Kim KI, Song SJ. Robot-assisted total knee arthroplasty does not improve long-term clinical and radiologic outcomes. J Arthroplasty, 2019, 34(8): 1656-1661.
18.	St Mart JP, de Steiger RN, Cuthbert A, et al. The three-year survivorship of robotically assisted versus non-robotically assisted unicompartmental knee arthroplasty. Bone Joint J, 2020, 102-B(3): 319-328.
19.	Redmond JM, Gupta A, Hammarstedt JE, et al. The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty, 2015, 30(1): 50-54.
20.	Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon's experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure-A cohort study. Int J Surg, 2020, 77: 174-180.
21.	Kayani B, Konan S, Huq SS, et al. The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty. Hip Int, 2021, 31(3): 311-319.
22.	Kayani B, Konan S, Huq SS, et al. Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1132-1141.
23.	Vermue H, Tack P, Gryson T, et al. Can robot-assisted total knee arthroplasty be a cost-effective procedure? A Markov decision analysis. Knee, 2021, 29: 345-352.
24.	Moschetti WE, Konopka JF, Rubash HE, et al. Can robot-assisted unicompartmental knee arthroplasty be cost-effective? A markov decision analysis. J Arthroplasty, 2016, 31(4): 759-765.

1. 裴国献. 数字骨科: 骨科领域的第三次技术浪潮. 中华创伤骨科杂志, 2019, 21(1): 3-5.
2. Picard F, Deakin AH, Riches PE, et al. Computer assisted orthopaedic surgery: Past, present and future. Med Eng Phys, 2019, 72: 55-65.
3. Radermacher K, Tingart M. Computer-assisted orthopedic surgery. Biomed Tech (Berl), 2012, 57(4): 207. doi: 10.1515/bmt-2012-0401.
4. Jacofsky DJ, Allen M. Robotics in arthroplasty: A comprehensive review. J Arthroplasty, 2016, 31(10): 2353-2363.
5. Batailler C, White N, Ranaldi FM, et al. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1232-1240.
6. Agarwal N, To K, McDonnell S, et al. Clinical and radiological outcomes in robotic-assisted total knee arthroplasty: A systematic review and meta-analysis. J Arthroplasty, 2020, 35(11): 3393-3409.
7. Manning W, Ghosh M, Wilson I, et al. Improved mediolateral load distribution without adverse laxity pattern in robot-assisted knee arthroplasty compared to a standard manual measured resection technique. Knee Surg Sports Traumatol Arthrosc, 2020, 28(9): 2835-2845.
8. Gordon AC, Conditt MA, Verstraete MA. Achieving a balanced knee in robotic TKA. Sensors (Basel), 2021, 21(2): 535. doi: 10.3390/s21020535.
9. Nodzo SR, Chang CC, Carroll KM, et al. Intraoperative placement of total hip arthroplasty components with robotic-arm assisted technology correlates with postoperative implant position: a CT-based study. Bone Joint J, 2018, 100-B(10): 1303-1309.
10. Illgen RL, Bukowski BR, Abiola R, et al. Robotic-assisted total hip arthroplasty: Outcomes at minimum two-year follow-up. Surg Technol Int, 2017, 30: 365-372.
11. Domb BG, Redmond JM, Louis SS, et al. Accuracy of component positioning in 1980 total hip arthroplasties: A comparative analysis by surgical technique and mode of guidance. J Arthroplasty, 2015, 30(12): 2208-2218.
12. Nawabi DH, Conditt MA, Ranawat AS, et al. Haptically guided robotic technology in total hip arthroplasty: a cadaveric investigation. Proc Inst Mech Eng H, 2013, 227(3): 302-309.
13. Kayani B, Tahmassebi J, Ayuob A, et al. A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty. Bone Joint J, 2021, 103-B(1): 113-122.
14. Kayani B, Konan S, Tahmassebi J, et al. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. Bone Joint J, 2018, 100-B(7): 930-937.
15. Shaw JH, Lindsay-Rivera KG, Buckley PJ, et al. Minimal clinically important difference in robotic-assisted total knee arthroplasty versus standard manual total knee arthroplasty. J Arthroplasty, 2021, 36(7S): S233-S241.
16. Kim YH, Yoon SH, Park JW. Does robotic-assisted TKA result in better outcome scores or long-term survivorship than conventional TKA? A randomized, controlled trial. Clin Orthop Relat Res, 2020, 478(2): 266-275.
17. Jeon SW, Kim KI, Song SJ. Robot-assisted total knee arthroplasty does not improve long-term clinical and radiologic outcomes. J Arthroplasty, 2019, 34(8): 1656-1661.
18. St Mart JP, de Steiger RN, Cuthbert A, et al. The three-year survivorship of robotically assisted versus non-robotically assisted unicompartmental knee arthroplasty. Bone Joint J, 2020, 102-B(3): 319-328.
19. Redmond JM, Gupta A, Hammarstedt JE, et al. The learning curve associated with robotic-assisted total hip arthroplasty. J Arthroplasty, 2015, 30(1): 50-54.
20. Kong X, Yang M, Jerabek S, et al. A retrospective study comparing a single surgeon's experience on manual versus robot-assisted total hip arthroplasty after the learning curve of the latter procedure-A cohort study. Int J Surg, 2020, 77: 174-180.
21. Kayani B, Konan S, Huq SS, et al. The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty. Hip Int, 2021, 31(3): 311-319.
22. Kayani B, Konan S, Huq SS, et al. Robotic-arm assisted total knee arthroplasty has a learning curve of seven cases for integration into the surgical workflow but no learning curve effect for accuracy of implant positioning. Knee Surg Sports Traumatol Arthrosc, 2019, 27(4): 1132-1141.
23. Vermue H, Tack P, Gryson T, et al. Can robot-assisted total knee arthroplasty be a cost-effective procedure? A Markov decision analysis. Knee, 2021, 29: 345-352.
24. Moschetti WE, Konopka JF, Rubash HE, et al. Can robot-assisted unicompartmental knee arthroplasty be cost-effective? A markov decision analysis. J Arthroplasty, 2016, 31(4): 759-765.

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