Orthopedic surgeons at Emory Johns Creek Hospital use robotic technology to perform knee replacements. Accordingly, robotic surgery offers enhanced precision and accuracy, decreases complications, and ensures faster recovery and shorter hospital stays. It is one of the knee replacement procedures that utilizes technological advancements. Besides robotic surgery, 3D printing, artificial intelligence (AI), and machine learning (ML) are some of the methods applied to increase surgical accuracy and anticipate patient outcomes.
Robotic Surgery
Roughly 3.6 million total knee replacement surgeries were undertaken in 2023, according to the Global Procedure Volumes Database of the LSI. Around 40% of these procedures take place in the US. An aging population, rising obesity rates, and increased prevalence of knee osteoarthritis are the driving factors behind the high volume of surgeries. Prior to surgery, the patient will undergo a computed tomography (CT) scan of the knee. A 3D model will be created that will include the specific bone structure, joint alignment, and the condition of the damaged cartilage.
In effect, the model will serve as a surgical blueprint that the surgeon will use to plan every detail of the procedure, including determining the exact size and placement of the implant, angles for bone cuts, and how to balance the ligaments.
During the surgery, the robotic system will guide the surgeon. The trackers will be placed on the patient’s leg, which will communicate with the robotic system, providing real-time data on the exact position and motion of the knee. The robotic arm or a hand-held device will be controlled by the surgeon, providing visual, auditory, and tactile feedback to guide the doctor’s movement.
The robotic system also ensures that the surgeon does not wander from the predetermined parameter, avoiding wrong bone cuts. Once the bone cut is prepared, the surgeon places the artificial components within the knee joint and closes the incision using sutures or staples. Essentially, robotic surgery is a highly controlled and accurate method for performing total knee replacements.
3D Printing and Personalized Implants
Additive manufacturing, which is another term for 3D printing, is a transformative technology in total knee replacement (TKR) surgery. It can be used to design and manufacture operating instruments or personalized knee implants, providing a better fit and improving patient outcomes. The procedure often begins with a high-resolution CT or magnetic resonance imaging (MRI) scan of the patient’s knee, translating the scan data into a high-precision digital 3D model of the patient. The digital model helps surgeons and biomedical engineers plan carefully for the surgery.
For custom implants, 3D printing can create femoral or tibial components that are 3D-printed to match the patient’s individual anatomy. The 3D printer will build the implant layer by layer, allowing the additive manufacturing process for complex geometries. A custom-fit implant can feel more natural, preserve more of the patient’s natural bones, and reduce the risk of implant overhang. Thus, 3D printing in TKR enables the creation of patient-specific tools and implants, leading to a better fit and a more functional knee, significantly improving long-term success for the patient.
AI and ML
AI provides immense value preoperatively for the patient by analyzing vast data sets of patient information like demographics, medical history, lifestyle factors, and imaging data. It can assist doctors in identifying which patients are ideal candidates for TKR by considering several factors. Therefore, it determines which patients are most likely to benefit from the surgery and which individuals might be better suited for alternative treatments, potentially reducing unnecessary procedures.
On the other hand, ML algorithms are capable of analyzing X-rays and MRI scans accurately. Thus, ML can detect and classify knee osteoarthritis severity and predict the best implant size and position for a patient, thereby reducing human error threats. The robotic systems used in TKR are powered by AI and ML. Furthermore, AI also assists with a patient’s post-operative recovery by creating personalized physical therapy (PT) plans based on their progress. Data from wearable devices can indicate a patient’s range of motion or step count, while continuous analysis of their information can predict the risk of complications like an infection or poor recovery.
TKR surgeries nowadays have become easier on patients and surgeons due to technological advancements and the refinement of surgical techniques. Robotic surgery, 3D printing, AI, and ML make the procedure less invasive and more precise and while improving recovery predictions.
This article was written for WHN by Bri Burton, who is a talented wordsmith, an avid blogger, and a health advocate.
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