Wednesday, April 10, 2024

Pros And Cons Of Robotic Hip Replacement Surgery

What Are The Benefits Of Robotic Surgery

How long does robot-assisted hip replacement surgery take? Is it quicker than other methods?

Robotic-assisted technology is designed to assist the surgeon with surgery, leading to more accurate and reproducible outcomes.

The major benefit of robotic-assisted surgery is that it allows for a specific plan personalised to your anatomy. This surgical plan can then be implemented with precision and accuracy, and refines the surgical procedure to pre-planned areas only, which reduces soft tissue damage around the site of surgery.

Dr Ward has particular interest in mini-invasive partial knee replacement using robotic-assisted surgery.

Potential Disadvantages Of Anterior Hip Replacement

Anterior hip replacement does have a few limitations:

There may be wound healing issuesResearch suggests that people who undergo anterior hip replacement may be more likely to have a problem with wound healing, particularly infection. For example, a study of 505 anterior hip replacements and 1288 posterior hip replacements found that 7 of the anterior hip patients had wound healing problems compared to 5 of the posterior patients.2Christensen CP, Karthikeyan T, Jacobs CA. Greater prevalence of wound complications requiring reoperation with direct anterior approach total hip arthroplasty. J Arthroplasty. 2014 Sep 29:1839-41. Epub 2014 May 2.

While wound-healing issues are usually mild and self-limiting , some may involve an infection of the new hip joint, which is a serious concern.

Obese or very muscular people may not be good candidatesDepending on the surgeon’s experience, this surgery may not be appropriate for obese or very muscular patients, because the additional soft tissue can make it difficult for the surgeon to access the hip joint.

It is a technically demanding surgerySurgeons face a steep learning curve for this procedure. The anterior incision provides a restricted view of the hip joint, making it a technically demanding procedure.

See Total Hip Replacement Surgical Procedure

If The Surgeon Is Still Doing The Surgery Why Use A Robot

In orthopedics, most of the robots use a combination of preoperative imaging fed into a software program, sensors used during the surgery, and a single robotic surgical arm. These things are used together to help the surgeon remove the smallest amount of bone possible to prepare for placing the implants, select the best implant sizes, and place the implants in the best possible position for YOU!

Our bodies are all a little different, and what works in one person might not work well at all in another. Sometimes, moving the implant, even a hair backward or forwards, side to side, and up and down, can make a significant difference in how your knee or hip will feel. The robot can give the surgeon information about the pressure, alignment, and motion in a joint down to very tiny amounts. This feedback allows the surgeon to make these very small but important adjustments to give you the best feeling result after surgery.

Besides the ability to make smaller cuts, there are other advantages. Human hands, even those belonging to an excellent surgeon, are never going to be perfect. Ever notice how your hands can shake if you have too much caffeine?

Well, a robot will never feel jittery. There are also limits to how small of movements we can make with our human fingers, even when using the most advanced surgical tools. But a robot can make extremely small, precise, controlled movements very easily.

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Pros Of Of Robotic Assisted Surgery

Mako joint replacement technology has been widely welcomed and there are, without doubt, many benefits:

  • It allows surgeons to create a personalised surgical plan so they can position the implants with absolute accuracy.
  • The standard replacement joint prosthesis is individually optimised to match the patients anatomy for greater freedom from pain from any mismatch.
  • Intraoperatively the system maps the patients natural joint movement patterns, helping to minimise excessive stress on the soft tissues and ligaments. This should ensure that they will be able to move in a natural way once the implant is in place.
  • There appear to be fewer prosthesis complications after surgery
  • Rehabilitation times tend to be shorter.
  • There is less chance of implant failure with possible less need for revision surgery.
  • Safety is improved. With the Mako system turned on, surgeons can only perform within their pre-operative plans due to the robot restricting cutting outside of the pre-planned area. This reduces the risk of human error.
  • There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed.

Pros Of Robotic Total Knee Replacement Surgery

100th MAKO Robotic Assisted Surgery Case at Nuffield Cambridge
  • The most significant benefit of using a robotic arm is that it provides greater accuracy than before. This is crucial when making bone cuts. This significantly lowers the risk of post-surgical complications and the need for a re-procedure.
  • The risk of blood loss is reduced as the programmed robot can only perform the procedure within the area mapped out by the plan designed by the surgeon.
  • From a patients perspective, this allows a faster recovery and lesser pain when the data is accurate. It also ensures improved safety and a reduction in post-operative complications.

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What Can I Expect When I Come Home From The Hospital

Youll receive at-home care instructions that are specific to the procedure you had. They typically include:

  • Taking it easy for a few days or however long your surgeon recommends.
  • Resuming everyday activities gradually. If youre not on prescription pain medications, you can start driving when youre ready.
  • Not lifting anything heavy until you follow up with your doctor.
  • Watching for signs of infection near your incision site.
  • Taking medications for pain or constipation.

Compliance With Ethical Standards

Brian Chalmers and Paul Sousa have nothing to disclose.

Peter Sculco is a paid consultant for Lima Coporate, Intellijoint Surgical, and EOS imaging he has also received research support from Intellijoint Surgical.

David Mayman receives stock options from OrthAlign, Imagen, Insight, and Wishbone he is a board member of the Knee Society he is a paid consultant and has received research support from Smith and Nephew.

Seth Jerabek receives stock options from Imagen Technologies and has received research support, paid honoraria, consulting fees, and royalties from Stryker.

Michael Ast is a board member of AAHKS and EOA he is a paid consultant for Stryker, Surgical Care Affiliates, Smith and Nephew, OrthAlign, and Conformis he receives stock options from Osso VR and OrthAlign he has received research support from Smith and Nephew.

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Inclusion And Exclusion Criteria

All articles of any study design directly reporting on complications and downsides of the robotic system in TKA were considered for inclusion. Intraoperative complications, such as pin-hole fracture, iatrogenic soft tissue and bony injury, excessive blood loss, longer operative duration, aborting a robotic TKA due to different reasons and postoperative issues, such as pin-related infection, longer hospital stays and post-TKA stiffness, were noted. Any other complications and downsides of this technology were also reported. Non-English studies, non-peer-reviewed studies, review articles, case reports, surgical techniques, conference abstracts, non-clinical studies as well as studies solely focused on robotic unicompartmental knee arthroplasty, computer-assisted total knee arthroplasty, or navigated total knee arthroplasty were excluded.

The Cochrane risk of bias tool for randomized controlled trials and methodological index for non-randomized studies tool for observational studies was used for the quality assessment of the included studies. Two authors independently performed the quality assessment for each article. A third author was consulted in case of disagreement.

The Pros Of Robotic Surgery

A Decade of Robotic Hip and Knee Replacement Surgery | NCH Healthcare System

Here are some of the advantages or good things that people may acquire if they choose to undergo robotic surgery:

Robotic surgery can be performed in a less restraining manner. This is a manifestation that all the patients who are undergoing the surgery can be operated with just a minimum number of physicians that eventually reduces the costs of medical bills.

Reduce cost of the medical bills that patients will be paying is very important for the people. Doctors can also operate patients even from distant places without reducing the quality of their services and health care assistance for their patients.

Robotic surgery operations is not as tiring as regular surgical operations does. Doctors who are operating and treating their patients with robotic surgery eliminates strain and other body pains since the procedure can last for just a short period of time.

Robotic surgery allows precision as well as accuracy of the method compared to other types of surgery that are commonly rendered by doctors and physicians.

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If Robots Improve Surgical Outcomes Why Doesnt Every Surgeon Use One

Many reasons:

  • Robots are not cheap! Hospitals often must be convinced that it will be worth it to buy the equipment and that it will be used often enough to justify the cost. Some of these robots can cost upwards of a million dollars!
  • It takes a lot of time and practice to learn how to do surgeries using a robot.
  • Robots can only be used for certain kinds of surgeries, and the FDA must approve each type.
  • Not every FDA-approved robotic-assisted surgery shows advantages for patients.
  • Not every patient is a candidate for robotic-assisted surgery.

If You’re Scheduled For Robotic Surgery

1. Ignore the hype: According to a 2011 Johns Hopkins study, hospital websites often cite studies comparing robotic surgery with open surgery instead of with minimally invasive procedures. “Many claims of superior safety and effectiveness are misleading,” says Marty Makary, M.D., of Johns Hopkins.

2. Weigh the options: Think twice about having robotic surgery for routine procedures such as hysterectomy, gallbladder removal, hernia repair, appendix removal, gastric bypass and standard colon surgery. Conversely, the robot’s dexterity may pay off for complex cancer surgeries, head and neck tumors, and throat cancer, as well as procedures for which there is no minimally invasive choice.

3. Ask questions: Some patients aren’t told that their surgery will be performed with the assistance of a robot, so if you’re scheduled for surgery, ask. If a robot will be used, ask whether there are alternatives.

4. Select the right doctor: That is, one who has had practice with the robot has performed routine surgeries at least 20 times, experts say. UCLA’s Jim C. Hu, M.D., advises finding a surgeon who has fellowship training in robotic surgery, and who has practiced robotic surgical skills for more than a year.

The bottom line: It’s important to weigh the pros and cons of robotic surgery carefully. Ultimately, your comfort level and your doctor’s experience should trump all other considerations.

Beth Howard is a freelance writer.

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Reno Orthopedic Surgery Center Begins Use Of Northern Nevadas Only Mako Robot

Northern Nevadas most experienced joint replacement team just obtained a new member the Stryker Mako Robot. We met up with Drs. Chad Watts, MD and Sanjai Shukla, MD from Reno Orthopedic Clinic to discuss how the robot will affect joint replacement care for patients at their new state of the art outpatient surgery center.

The Benefits Of Robotic

Treatment for Osteochondral Defects (OCDs)

Perhaps the biggest advantage of robotic assistance is precision. Your ability to walk naturally depends on the accurate placement of your hip prosthetics. With robotic-assisted surgeries, hips can be replaced with much more precision than can be done manually. With the Mako® robotic system, Dr. Dalal can make sure your procedure is performed exactly as it should be.

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What Happens During Robotic Surgery

  • First, your surgeon makes one or more small incisions.
  • Through these incisions, your surgeon places ports . The robot is attached to these ports and instruments are then placed through them.
  • A long thin camera is placed through one of the ports. The camera provides high-definition images in 3D during the surgery.
  • Surgical instruments are placed through the other ports, which allows the surgeon to do the operation.
  • Your surgeon controls the robotic arm while sitting at a console a few feet away from you.
  • An assistant stays next to you to help the surgeon by changing the instruments when needed.

Ways Of Improving Robot

Its important that centers applying robotics follow standardized training, improved reporting and enhanced patient education to reduce errors related to robotic surgery. Robotic surgery should be conducted by urologic surgeons trained in robotics and have extensive robotic and laparoscopic surgical experience. It also must be remembered that adding robots to the surgical equation may create room for error in an already risk-fraught and complex arena. So proper steps must be taken to guarantee safe and effective robot-assisted procedures. Robotic surgery is getting better and better as more advanced robots are developed to overcome existing shortcomings. So patients should expect better outcomes with robot-assisted surgery as advanced machines are applied.

At Advanced Urology Institute, we believe that surgical outcomes are a direct manifestation of the experience and skill of the surgeon, and less about the approach or technology used. Thats why we have assembled a team of qualified, skilled and experienced urologists to offer surgical procedures for different urological disorders. Our urologists perform hundreds of laparoscopic and robotic surgeries every year and have achieved great success rates in terms of efficacy, cure and improved quality of life. Our approach to robotic surgery guarantees that you will get the best possible surgery with remarkable outcomes. For more information, visit the Advanced Urology Institute site.

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Procedure For Rosa Robotic

In general, the ROSA robotic-assisted anterior hip replacement procedure using the ROSA system is similar to that of a traditional hip replacement procedure but performed with the help of a robotic assistant in an anterior approach. The robotic system does not perform the procedure on its own. The surgery is performed entirely by your surgeon by prompting the robotic hands as per the personalized plan developed by your surgeon. The ROSA system is only an additional tool to guide your surgeon and ensure greater accuracy in the placement of the hip implants. It cannot replace the skills of your experienced surgeon.

Potential Advantages Of Anterior Hip Replacement

Procedures in Total Hip Arthroplasty – MAKOplasty, Robotic Assisted Total Hip Replacements

Proponents of anterior hip replacement surgery believe it offers several advantages, including:

Less damage to major musclesThe anterior approach avoids cutting major muscles. There are fewer muscles at the front of the hip, and the surgeon works between them, rather than cutting through muscle fibers or detaching muscles from bones .

Less post-operative painBecause the surgery does not require cutting major muscles, patients typically experience less pain after surgery and require less pain medication.

Faster recoveryResearch suggests people who have anterior hip replacements stop using walkers, canes, and other assistive devices 5 to 7 days sooner than traditional hip surgery patients.1Taunton MJ, Mason JB, Odum SM, Springer BD. Direct Anterior Total Hip Arthroplasty Yields More Rapid Voluntary Cessation of All Walking Aids: A Prospective, Randomized Clinical Trial. J Arthroplasty. 2014 May 25. pii: S0883-540300340-4. doi: 10.1016/j.arth.2014.03.051. PubMed PMID: 25007723.

See Total Hip Replacement Surgery Recovery

Fewer postsurgical precautionsAfter hip replacement surgery, patients are given a list of precautionscertain movements and activities that should be avoided in order to prevent the new hip from dislocation.

Anterior approach surgeons tend to assign fewer or no postsurgical precautions. However, there is no clear consensus on this issue since some surgeons performing traditional hip replacement are also forgoing the post-operative hip precautions.

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Pros And Cons Of Hip Replacement Surgery

And how does it compare to ‘hip resurfacing’?

More than 330,000 hip replacement surgeries are performed in the United States each year.

A hip replacement may be done for various reasons. Certain conditions can damage the hip joint and result in needing to have the joint replaced — the two most common conditions being rheumatoid arthritis and osteoarthritis.

Rheumatoid arthritis is an autoimmune disorder which produces a type of inflammation that can erode bone and cartilage and deform joints. This disorder is characterized by an irregular assault of the immune system on the lining of the joint, the synovium. As a result, the joint becomes inflamed and fluid builds up resulting in pain.

Osteoarthritis on the other hand is commonly known as wear-and-tear arthritis. And it is this type of arthritis that we have more control over. Osteoarthritis damages the cartilage that covers the ends of bones and helps joints move smoothly. Cartilage acts as a cushion between the bones, protecting our joints from the stresses of daily activities. This degenerative joint disease is characterized by changes in the cartilage that normally sits between bones at the joint. As the cartilage wears away the space between the bone narrows, until the underlying bone is exposed. Pain eventually results from wear on the naked bone, as well as increased stress and fatigue of the muscles that support the joint.

The risks associated with hip replacement surgery may include:

What Are The Pros And Cons Of Robotic Knee Replacement Surgery

Robotic Knee Surgery is often the most effective joint replacement procedure available today for patients suffering from knee pain. The advantages of robotic knee surgery come from: optimized intra-operative stability, minimally invasive techniques, improved post-operative stability and increased patient satisfaction. The increased patient satisfaction is achieved due to optimized operative stability and reduced post-operative pain and swelling. Better outcomes and less pain and swelling are seen with robotic-knee-surgery-Adelaide than other knee replacement procedures.

The stability of robotic surgery is improved by minimizing movement risks during the procedure and micro-surgery principles. This minimally invasive technique improves stability by limiting the involvement of the knee cap during the process. As a result, it limits the degree of instability, which is common with other types of minimally invasive surgeries. In addition, the potential for instability is reduced by the fact that the femur is free to move in the plane of the femoral groove in the knee socket and align with the rotation of the femur and tibial plateau. As a result, the internal rotation of the femur occurs at a slower rate. It prevents the instability that is associated with the internal rotation of the femur.

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