What is Robotic Surgery?

Robotic Surgery is changing the way surgeons perform partial knee replacement. The Navio Surgical System utilizes image-free principles, meaning the patient does not have to schedule a pre-operative CT scan. Instead, the surgeon uses advanced tools to map the patient’s anatomy and kinematics (movement) during the procedure. This allows the surgeon to create a plan tailored specifically for the patient. A robotic-assisted handheld instrument aids the surgeon in accurate implant placement, but it is the surgeon in control. Read more information about Robotic Knee Surgery and the benefits here.

Robotic knee surgery, robotic surgery

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The Navio Surgical System

Navio’s touchscreen monitor and linear workflow are designed to leverage the surgeon’s strengths with the system’s advanced tools. The reproducible accuracy of Navio allows the surgeon to offer partial knee replacement to early- to-mid stage osteoarthritis sufferers who might otherwise only be offered total knee replacement. Partial knee replacement, while traditionally a difficult surgery to perform with consistency, can lead to excellent intermediary outcomes for younger, osteoarthritis sufferers when done well1.

Therefore, a surgeon who is more confident in offering partial knee replacement to their patients can utilize a procedure that when compared with total knee replacement may offer:

  • Less pain
  • Quicker rehabilitation and recovery
  • Lower risk of complications
  • Smaller incisions
  • Shorter hospital stay

Why Would Dr. Burke Recommend Robotic Surgery?

Dr. Burke may recommend robotic surgery for the following reasons:
  • Osteoarthritis in the knee
  • Athletic knee injury
  • Conditions that affect the knee joints

Symptoms of Needing Robotic Surgery

Patients with the following symptoms may need robotic surgery:
  • Pain in the knees
  • Reduced movement in the knee joints
  • Stiff or swollen knees
  • Pain that has not responded to non-surgical treatments

Benefits of Robotic Surgery with Dr. Burke Orthopedics

Beyond the potential benefits of a partial knee replacement over a total knee replacement, the Navio system provides:
  • Consistent results
  • Accurately placed implants
  • Customized planning
  • No CT radiation required

Dr. Burke's Innovative Robotic Surgery

Navio Surgery

With Navio for partial knee resurfacing, there is no special preparation or post-operative recovery protocol. During the robotic knee surgery, the surgeon will use advanced image-free navigation steps to create a virtual reconstruction of anatomy, soft-tissue/ligaments and kinematic motion of the knee. The surgeon uses this information to tailor the position of the implant to the patient’s femur and tibia shape, taking into account the patients unique cartilage wear and condylar shapes, and then balances their soft-tissue ligaments. Finally, the surgeon uses the Navio handpiece to sculpt the damaged bone away to accept the artificial joint. The robotic-assisted handpiece enforces the target surgical plan, making sure that the final placement of the implant is accurately placed according to the intended position.

Robotic Knee Surgery FAQ’S

What is partial knee replacement/resurfacing?

Partial Knee Replacement, or Partial Knee Resurfacing, or Partial Knee Arthroplasty represents a surgical procedure which replaces diseased (OA) bone with artificial surfaces. The surgical procedure occurs through a smaller or minimally invasive incision, and can treat either the medial, the lateral (inside or outside) compartment of the knee. Additionally, the patellofemoral joint (PFJ) (beneath the patella/knee cap) can be singularly resurfaced if damaged or more commonly in conjunction with the medial compartment. A PFJ and medial PKR combination surgery is referred to as bi-compartmental (two compartments of the knee) knee replacement. During PKR, the surgeon not only replaces the damaged joint, but re-balances the knee’s alignment. If a patient is several degrees out of neutral mechanical leg alignment, the PKR procedure can correct to near neutral – fixing bow-legged or knock-kneed deformities.

Why would I choose partial knee replacement over total knee replacement?

Partial Knee Replacement has certain potential benefits over a Total Knee Replacement procedure for those patients who are properly indicated for PKR1. Whereas TKR completely reconstructs the knee and often sacrifices both the ACL and PCL, a partial knee procedure preserves any functioning and healthy ligaments and only replaces the compartment(s) of the knee that have osteoarthritic damage. This means that the patient may recover quicker from PKR surgery than TKR because of the smaller incisions and limited disruption to the soft-tissue capsular structure2.

What are the results of partial knee replacement?

A well-done partial knee replacement in an appropriately selected patient can have the survival rate that is comparable to that achieved with a total knee replacement in the first decade following surgery. The literature suggests, after the second decade, the revision rate may be somewhat higher for partial knee surgery than for total knee surgery. There may be an advantage to prolonging function and reducing pain in the patient’s joint prior to a total knee replacement, which is an end-of-the-line option2.

Why does the Navio system work well for PKR?

The Navio system works well for PKR because it allows the surgeon to utilize advanced robotic-assisted technology for accurate bone cutting in a platform that does not require a pre-operative CT scan. The robotic-controlled handpiece puts the power of a robotic-arm into the surgeon’s hands for them to engage fully with the operational technique.

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References

  1. Borus T, Thornhill T. Unicompartmental knee arthroplasty. J Am Acad Orthop Surg. 2008;16(1):9-18.
  2. Hall et al., “Unicompartmental Knee Arthroplasty (Alias Uni-Knee): An Overview with Nursing Implications,” Orthopaedic Nursing, 2004; 23(3): 163-171
  3. Brown, NM, et al., “Total Knee Arthroplasty has Higher Postoperative Morbidity than Unicompartmental Knee Arthroplasty: A Multicenter Analysis,” The Journal of Arthroplasty, 2012.
  4. Repicci, JA, et al., “Minimally invasive surgical technique for unicondylar knee arthroplasty,” J South Orthopedic Association, 1999 Spring; 8(1): 20-7.
  5. Bolognesi M, et al. Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty Among Medicare Beneficiaries, 2000 to 2009. J Bone Joint Surg Am. 2013 Nov;95:e174(1-9).
  6. Lonner, Jess, et al. “High Degree of Accuracy of a Novel Image-free Handheld Robot for Unicondylar Knee Arthroplasty in a Cadaveric Study.” Clin Orthop Relat Res, DOI 10.1007/s 1999-014-3764-x

FAQ References

  1. Brown, NM, et al., “Total Knee Arthroplasty has Higher Postoperative Morbidity than Unicompartmental Knee Arthroplasty: A Multicenter Analysis,” The Journal of Arthroplasty, 2012.
  2. Borus T, Thornhill T. Unicompartmental knee arthroplasty. J Am Acad Orthop Surg. 2008;16(1):9-18.