Robotic-arm assisted surgery for full hip and knee replacement

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of your bones wears down over time. Osteoarthritis symptoms can usually be managed, although the damage to joints cannot be reversed. Staying active, maintaining a healthy weight and some treatments might slow the progression of the disease and help improve pain and joint function. But for some patients, especially the elderly, the joint pain or stiffness might be nagging to some extent which does not go away and hampers day to day activities. Many of them may require a surgical procedure.

Dr SS Sathappan, Senior Consultant, Orthopaedic Surgery and Medical Director of Bone and Joint Specialist Clinic at Farrer Park Hospital (FPH), Singapore recently shared about the prospect and advancement in the treatment of bone and joint problems.

Dr Sathappan, who has special interest in adult reconstructive surgery (joint replacement), sports surgery and management of complex pelvic and acetabular trauma and was the first surgeon to perform customised joint replacement explained about the robotic-arm assisted surgery for full hip and knee replacement procedure.

Robotic partial knee replacement (MAKOplasty®) is a surgical treatment designed to relieve pain in the knee caused by the wear and tear of joint cartilage. The partial knee resurfacing procedure is done using a robotic arm, which lets the surgeon treat only the damaged part of the knee. The precise nature of the procedure means healthy bone and ligaments surrounding the damaged area are spared from trauma.

To improve the position and the cutting tools, they use robotic technology. That basically brings the error rate to less than 0.5 percent – so very accurate, precise dock the implants, check back and then the patient gets a good outcome. As a result, the alignment is optimised, the kinematics is optimised and eventual functionality return to normality. A lot of ageing patients want to be able to sit cross-legged, squatting, natural activities and perform prayers. It helps to get the permission of doing all these activities.

In the conventional surgery, it depends upon the experience and there is no chance of going back. On the contrary, in the robotic procedure, the precision is very high and it gives a wide variety of flexibility to reduce the errors and improve the outcome to a great extent.

Dr Sathappan explained that the treatment modalities have changed a lot during the last couple of years. Now people are living longer, they are coming with higher demands and more functional expectations. So, half hip replacements are becoming less popular where patients develop pain and complications over period eight to ten years.

Surgery is really changing, expectations are changing, people want to be active, people do not want to be dependent any more – they want to be independent. It brings back the dignity of people by making them independent again.

Dr Sathappan concluded, "I think technology allows you to optimise the long term outcome from which you get the least amount of error; biomaterials optimise longevity of the programme and then empowering the patient with knowledge on therapy and how to maximise the outcome also ensures that the overall functionality - returned activity is as near normal as possible."