Robot-assisted surgery remains a burgeoning area in medicine—and the technology is improving every day. At University of Maryland Medical System (UMMS), surgeons use robotic-assisted surgery for both hip and knee replacements.
While some patients may question the safety of having this type of procedure, it is no more risky than traditional surgery—especially under the guidance of a highly skilled surgical team that is experienced with robotic-assisted surgery.
How is Robotic-Assisted Surgery Different From Traditional Surgery?
The steps leading up to robotic-assisted hip or knee replacements ensure that the surgeon has everything they need for a successful procedure. Patients first undergo a pre-operative CT scan, which is used to construct a 3D model of their joint. Surgeons rely on this model to determine where the implant will go, how much bone will need to be removed, and how to orient the implant.
This information allows for a level of accuracy that isn’t necessarily attainable with traditional surgery. During traditional surgery, the surgeon uses their vision alone to determine how to best orient and insert the implant.
Even in the best of hands, a margin of error exists with traditional surgery. One Harvard study even revealed that Harvard surgeons doing hip replacements were able to put a hip socket in at the perfect angle approximately 50% of the time. While this doesn’t mean that 50% of the patients had poor outcomes, ideally, the entire surgery process should be completely smooth.
Research on the Mako robot, which UMMS uses, has shown an accuracy rate of 87% in hip replacement. The same is true of partial knee replacement. In Swedish and Austrian registries, a 4% “redo” rate occurs with partial knee replacements using traditional surgery. That number goes down to 0.4% with robot-assisted surgery.
The Surgeon is Still in Control
There’s a reason the term is “robotic-assisted” surgery rather than simply “robotic surgery.” A human surgeon is still in full control of the procedure. The robot simply aids in finding the perfect alignment, which is important for positive outcomes long-term. It helps minimize some of the complications that can arise during hip replacement surgeries, such as dislocation, leg length inequality, premature wear, and bursitis (inflammation of the fluid-filled pads that cushion the joints).
However, studies on the long-term outcomes of robotic-assisted surgery patients are still pending. This technology is only about 10 years old, so the difference this type of surgery makes 20 or 30 years out is yet to be seen. However, the increased level of alignment and accuracy during robotic-assisted surgery suggests that the implant may last longer.
The Benefits of Robotic-Assisted Surgery
Hip replacement surgery can be done through an anterior (front) approach, posterior (back) approach, or anterolateral (both) approach. With a good surgeon, the vast majority of patients do wonderfully. Unfortunately, all surgery comes with risk. A small portion of the time, patients may have problems with leg length differences and dislocation, which are challenging problems to fix.
These issues are more prevalent in people with cartilage problems when the ligaments are looser than normal. It can also occur in people that have back arthritis or have undergone a previous spine surgery that causes their back to be stiffer than normal, making the hip compensate. In these cases, the precision of robotic-assisted surgery can be highly beneficial for reducing complications.
Robot-Assisted Surgery Recovery
Hip replacement patients typically require minimal help from a physical therapist—just enough to cover precautions and stretching exercises to use at home.
Physical therapy for partial knee replacements using the robot is about the same as a manual partial knee replacement (four to six weeks post-surgery).
You can generally return to previous activities within six weeks. There are certain precautions you must take have to minimize the likelihood of dislocations and allow yourself to heal. However, it is possible to live an active life after a hip or knee replacement.
Get the Joint Replacement Expertise You Deserve
Whether your joint replacement takes place through traditional or robotic-assisted surgery, having an orthopedic surgeon that’s experienced is essential for having the best outcome possible.
The University of Maryland Joint Network is home to Maryland’s leading joint replacement surgeons. Located throughout the state, UM Joint Network surgeons are unique among other orthopedic surgeons for their advanced expertise in total hip and knee replacements.
Patients treated by UM Joint Network surgeons often have better outcomes compared to the national averages, including lower infection rates and faster recovery times. This means that you not only receive better care but also get out of the hospital and back home faster.
Hear From Our Experts
Dr. Raj Yalamanchili, Director of Joint Replacement at UM Upper Chesapeake Health and member of the UM Joint Network, discusses the value of robotic surgery for joint replacement and how it works on the Live Greater Podcast.
