The Facts on Robot Assisted Joint Replacement Surgery

John Froehlich, MD
Robotic joint replacement

It’s hard to imagine our world without technology. Its use is evident in almost every aspect of our lives, and medicine is no exception. One example is the use of robot assisted surgeries for performing joint replacement procedures.

What is robot assisted joint replacement surgery?

There are many different systems that have been designed to assist surgeons who perform orthopedic surgery. Most systems focus on knee replacements, with newer models expanding to assist in hip replacements as well. Some systems require the patient to get a pre-operative computed tomography (CT) scan or magnetic resonance imaging (MRI), which is then analyzed and the system creates a plan for the surgeon to follow based on the imaging studies. Other systems rely on computer programs guided by the surgeon during the operation.

What are the advantages of this technology?

Some surgeons have adopted the use of computer and robotic technology because they feel they can do a better job performing the operation with this added tool.

In conventional replacement surgery, a surgeon uses jigs and alignment guides to place the component parts of the joint. Computer navigation and robotic technologies are intended to help improve accuracy in the placement of the new joint components. By using these systems, surgeons can improve the results of the procedure in terms of patient function and long-term results.

Some robotic systems suggest that the procedure can be performed through smaller incisions or less invasive techniques. However, studies that have looked at this, particularly in total knee replacement, seem to suggest that the benefits to this approach are questionable.

Are there any down sides or disadvantages?

Not surprisingly, the answer to this is yes. If the system requires a CT or MRI beforehand, it takes time and exposes you to radiation. Generally speaking, the use of these technologies can lengthen the duration of surgery. Some studies indicate that the longer the surgery, the higher the risk of infection.

There is no doubt that the use of these systems may improve the accuracy in the positioning of the replacement, such as the alignment of your knee. This may be of assistance particularly to a surgeon who does not do a lot of replacements. However, studies have shown that despite this alignment improvement, the outcome (how you do) is no better, nor is the durability (how long it lasts).  

Given these facts, some question whether this technology should be used regularly with little clinical benefit.  This is especially true when it can increase the cost of the procedure by as much as 40 percent.

What to do if you have arthritis

Although we currently do not have a cure for arthritis, many times your doctor can offer options that can reduce the effects of arthritis on your body. Your physician can certainly advise you as to what is most appropriate in your situation.

  • Medications like non-steroidal anti-inflammatory drugs (NSAIDS), or curcumin/turmeric can help control your symptoms and are generally safe.  
  • A regular exercise program combining stretching and strengthening often reduces the stiffness associated with the effects of arthritis.  
  • Injections, typically of a steroid, can help, particularly when one has an acute flare.
  • For the knees, we also have lubricant shots which can help in some cases.  

Time for surgery

If these conservative measures have not helped your arthritis symptoms,  and you feel your day to day activities have been limited, replacement surgery may be an option for you.  Many advances have been made both in surgical techniques and materials and the success rates are very high.

Hip and knee replacements can easily last more than 20 years, with excellent improvement in function. Fellowship trained orthopedists specializing in joint replacement  generally have the most experience doing these procedures. Multiple studies show that surgeons who regularly perform certain procedures at hospitals where these surgeries are done on a daily basis have the best outcomes and the fewest complications.

The Total Joint Center

The hip and knee surgeons at The Miriam Hospital Total Joint Center are all specialty/fellowship trained. In 2019, we performed over 1800 replacement surgeries. Our infection rate is extremely low (0.3%) and much better than national averages of one to two percent.

The recovery process is always a consideration for patients. Over 80 percent of our patients return directly home without the need to go to nursing facilities. Some of our patients can even go home the same day without the need for any hospital stay. Our team provides guidance throughout the care process, including an education program, a nurse navigator and a dedicated team in the operating room and a special unit in the hospital for our patients.  

The surgeons at the Total Joint Center continue to evaluate and consider new innovations as they become available and will incorporate those technologies that improve patient care and outcomes.  We are committed to providing the highest quality care to our patients at all times.

We welcome the opportunity to help you. Learn more about joint replacement surgery on our website, or give our Total Joint Center a call at (401) 793-4830.

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