9 March, 2021
Robotic knee replacement surgery achieves greater precision and customisation
New equipment acquired by the Hospital Clínic Group allows for both early planning that is more adapted to each specific case, as well as assistance during surgery to improve its precision and accuracy. Thanks to this increased customisation and precision, patient recovery is better and faster and the knee prosthesis is also more durable.
Hospital Clínic, the first in Catalonia to perform robotic knee replacement surgery
In recent years, technological advances have led to robotic arms becoming a resource that is increasingly used in surgery. Their greater precision and accuracy means less aggressive surgery can be performed, resulting in swifter patient recovery. Now, departments at the Hospital Clínic Group can make use of the ROSA® robot, from Zimmer Biomet, for performing knee replacement surgeries. The hospital was the first in Catalonia to perform robotic knee replacement surgery.
The first robotic knee replacement surgery was performed on 11 December by Dr Pere Torner, a traumatologist at barnaclínic+ and head of the Hospital Clínic’s Orthopaedic Surgery and Traumatology Department, and by Dr Juan Carlos Martínez Pastor, also from the barnaclínic+ Traumatology department and head of the knee section. “The precision that robotic surgery provides translates into operations that will require less surgical exposure and, therefore, less soft tissue involvement and fewer bone resections”, explains Dr Juan Carlos Martínez Pastor.
Advantages of robotic knee replacement surgery
Better surgical planning
Thanks to the new ROSA robot, surgeons can better plan the robotic knee replacement surgery, quantifying all the parameters of the procedure more precisely. “This allows us to fine-tune the size and type of prosthesis needed for each patient, adapting it to the characteristics of each specific case”, notes Dr Pere Torner.
This prior customisation, made possible thanks to the new equipment, means that subsequent sections on the tibia and femur are much more precise, helping to better maintain ligament tension. Factors which all have a bearing on post-operative recovery, as Dr Torner explains. “Ultimately, this means that recovery from surgery is better and faster. And since they are prostheses that are actually much better adapted to the patient, they end up being more durable and offer better clinical outcomes.”
“Robotic knee replacement surgery offers better and faster recovery, as well as improved clinical outcomes and greater prosthesis durability”
High precision during surgery
The second great advantage that the new ROSA® robot offers surgeons is that processes can be performed much more precisely and accurately during the procedure itself, thanks to the assistance they receive from the robotic arm. “The system allows the different 0.5-mm cuts to be modified on any of the spatial planes to find the best possible adaptation of the prosthesis in each patient”, points out Drv Juan Carlos Martínez Pastor.
“The new ROSA robot allows us to find the best possible adaptation of the prosthesis in each patient”
In addition to high-precision cutting, this new robotic knee replacement surgery allows the prosthesis to be implanted in the most suitable position. This means that the axis of the joint can be restored and, most importantly, the ligaments can be balanced correctly throughout the knee joint. “In short, our aim is to perform more personalised and better planned surgery, with a more precise implant placement and, above all, to ensure that patient quality of life and satisfaction are as high as possible”, concludes Dr Pere Torner.
About knee replacement
When a knee is badly worn, surgery needs to be considered in order to both alleviate the pain caused by the poor condition of the joint and to recover its functionality. It is a procedure that is normally recommended when pharmacological treatment is unable to control the pain or when function is severely impaired.
In procedures of this type, the surgeon removes damaged cartilage and bone from the surface of the knee joint and replaces them with artificial metal and plastic surfaces. This new prosthesis can wear out, which means that replacement surgery will need to be considered after 15 to 20 years.
The Hospital Clínic Group has extensive experience in this type of surgery, performing around 350 operations a year to fit primary prostheses and up to 150 prosthetic replacements. “This number of replacements is very high, but this is because we are a national referral centre (CSUR) for complex prosthetic knee conditions and sepsis”, affirms Dr Pere Torner.
“We are a national referral centre for complex prosthetic knee conditions and sepsis”
The Rapid Recovery programme
As a result of more than 12 years of experience, the Hospital Clínic Group also offers its Fast-Track or Rapid Recovery programme, from which patients undergoing robotic surgery can also benefit. This programme requires the active participation of patients in decision-making and in their own recovery process. In this way, we strive to achieve better surgical outcomes, as well as higher quality of life after surgery.
To achieve this, the programme proposes actions both before and immediately after surgery, as well as in the longer term. As such, patients participate beforehand in a workshop in which they are given information to better understand their condition and about the surgical process, and questions that need to be taken into account for their recovery are also addressed, such as walking with crutches or how to go up and down stairs.
The Rapid Recovery programme also stresses the need for patients to start standing up, moving around and walking within a few hours of surgery. The purpose of this is to improve pain control, work the muscles and the venous system and reduce the risk of venous thrombosis; i.e. the formation of blood clots that can detach and lead to serious problems, such as a pulmonary embolism, heart attack or stroke.