Robotic Knee Replacement Current Evidence Based Status

Robotic surgery is a technique for performing surgery using small instruments combined to a robotic arm. The surgeon utilizes a computer to control the robotic arm. Dr Abhishek Patil is the most experienced Orthopaedic doctor provides the best Robotic Surgery in Kharadi, Pune.

Robotic knee replacement was originally conceived around the year 2008. The initial systems invented were found to be not so effective clinically for patients nor in terms of cost effectivity.

Robotic knee replacement was reinvented with newer systems around the year 2014- 15 with advent of Mako Robotic system by Stryker. Following on these grounds, other companies rapidly introduced their individual systems. India saw the begining of Robotic era in knee replacement around 2016-17.

Currently the available robotic systems in India are as follows

Mako by Stryker

Rosa by Zimmer

Velys by Depuy / Johnson

Cori by Smith and Nephew

Cuvis by Merill

While all the above systems are compatible with knee replacement, it is important to note that only the Mako system by Stryker is capable of doing a Hip Replacement and no other system ( as on date).

Currently as on date, based on data of around 10 years with the available SCIENTIFIC LITERATURE the following conclusions can be derived and are internationally accepted

Robotic knee replacement has early benefit over the conventional knee replacement ( only first 6 weeks) in terms of early recovery and minimal advantage in terms of pain
In terms of clinical function after 6 weeks, there is no advantage whatsoever.
When compared with conventional knee replacement, Robotic surgery offers NO LONG TERM BENEFIT TO THE PATIENT.
The so called improved alignment with Robotic surgery, DOES NOT translate into a better outcome for the patient, as Experienced surgeons get their alignment accurate in most cases, within the scientifically proven range of acceptability (+- 3 degrees)
The FALSELY CLAIMED advantages of
- Smaller Incision
- Less bone loss
- Less blood loss
- No Physiotherapy required
- ARE NOT PROVEN IN LITERATURE and are merely used as tools for marketing
The final verdict as on Jan 2024 is
AT BEST ROBOTIC SURGERY IS NOT INFERIOR TO CONVENTIONAL KNEE REPLACEMENT HOWEVER ITS SUPERIORITY IS YET TO BE PROVEN
With no scientifically proven advantage, the additional costs of Robotic surgery as on today is unjustified.

Last but not the least,

Robotic knee replacement has it’s very well defined and independent set of complications, with higher incidence of

Fractures around knee following surgery
Higher incidence of Quadriceps muscle injury As compared to conventional knee replacement, which is not spoken of much so as to preserve the Image of Robotic surgery and keep the patients unaware.

In the end, to conclude, Robotic surgery for knee replacement is an evolving technology which till date has not conclusively proven it’s superiority over conventional knee replacement ( with a data of over 10 years) and will need to be validated with scientific data in years to come. A wise and Experienced surgeon still remains the cornerstone in getting a good result in hip or knee replacement and patients need to be aware and choose their surgeon wisely without falling prey to marketing gimmicks.

Robotic Knee Replacement Current Evidence Based Status

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