Joint replacements used to be done using averages for all patients, with standard angles and instrumentation. With the new robotic technology to help us in joint replacements, surgeons can now tailor replacements more specifically to a person: to their alignment, their anatomy, and their arthritis.
Any patient who is a candidate for a joint replacement is a candidate for a robotic joint replacement. A robot is just a tool that your surgeon is using to execute the plan that is best for you, so the criteria are the same and the cost is the same.
Recovery time after robotic and non-robotic joint replacement is about the same, although patients may recover a little faster from a robotic surgery since there is a little less cutting of the tissue under your skin. However, both methods have similar results in terms of how easily you can move your joint, bend your joint, do physical therapy, and otherwise recover.
While several different companies make systems and surgeons are trained on the specific system that they use, the systems have some similarities. Your X-rays, CT scans, and/or MRIs are loaded into the robotic system before surgery. During surgery, your surgeon registers, or tells the system, where your body is in relationship to the robotic system.
The robot doesn’t do any part of your surgery on its own: the surgeon is controlling it the entire time. The robot helps the surgeon by keeping a saw at the correct angle or helping the surgeon move a guide the right number of millimeters. It helps the surgeon stay in the right path to create the exact alignment that they want to be in.
Training for surgeons
Surgeons receive extra training on using the robotic systems. I received my training during my fellowship, where we used it heavily. When a new system is introduced, surgeons go to a course at a facility to learn about the system and to be trained to use it safely.
Before using a new robotic system on patients, surgeons practice on models and on cadavers. The models, called sawbones, are made of plastic foam and are fake versions of bones. An inexpensive, replaceable tool, they are a safe way to learn how to operate a new machine. Once a surgeon has mastered the technology on sawbones, they can work on cadavers, from people who have donated their bodies to science. Using cadavers allows the surgeons to practice with real bones, ligaments, muscles, and so on.
Frequently asked questions
How does using the robot change the length of time of surgery?
Different joint replacements take different amounts of time. However, robotic surgeries for a specific joint take about the same amount of time as non-robotic surgeries of that same joint. The first or second time a surgeon uses a new robotic technology the surgery might take slightly longer, but a surgeon who is used to a robotic system won’t be any slower.
Do joint replacements done with a robot count as minimally invasive?
Minimally invasive is a selling point more than a term with a strict definition. Most people consider a surgery to be minimally invasive or not based on the size of their scar, but the actual scar you see doesn’t reflect how invasive a surgery is inside your body. With robotic technology for joint replacement, sometimes there are extra pinholes for instruments but the size of the main incision is about the same size to fit the implant into place.
Is using robots during surgery like playing a video game?
Using robots during surgery is a little bit like a video game, and because younger surgeons have more experience with video games than older surgeons do they can sometimes learn the new robotic systems faster. There isn’t a controller like a video game, but you are using tools to register points of the bone with the system so the computer knows where your joint is in space.