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Robotic technology in total joint replacement surgery.

There is no doubt that all aspects of surgery have improved rapidly in the last twenty to thirty years, spurred on by massive technological advances. This has had a positive impact on surgical outcomes and quicker post-operative recoveries in the field of joint replacement surgery.

In the twenty-first century, fueled by patient expectations for the “best treatment”, there has been an explosion of computer-assisted and robotic surgical technology used by joint replacement surgeons to maximise patient post-operative satisfaction and artificial joint survivorship. This role will continue to evolve and will undoubtedly become standard practice, but the role of the surgeon is unlikely to be entirely eclipsed by artificial intelligence. At this stage the use of such technology, be it computer navigation, patient specific, or robotic assisted, is dependent on the surgeon’s technical abilities and experience to acquire optimal results.

In the early nineties, the ROBODOC assisted hip replacement system was developed and trialed: the project found that femoral stem placement and fixation in total hip replacement was not any better with ROBODOC than with standard surgical techniques.

Patient specific instrumentation for total knee replacement surgery has recently been found to be inferior than the use of conventional bone cutting jigs.

Recently, current generation robotic-assisted technology has been found to have no significant improvement in outcomes measures compared to conventional techniques in total knee replacement, at ten-year follow-up. Given additional associated increased cost and time investment in the surgery, a recent scientific paper could not recommend current robotic surgery.

Computer navigation assisted knee replacement surgery has however been proven to be associated with improved outcomes in the Australian Joint Replacement Registry.

Robotic surgery is here to stay but at present is evolving and in itself does not guarantee an optimal outcome following knee and hip replacement surgery.

Notwithstanding all this, our surgeons continue to have an interest in this exciting area of surgery; however, surgeon ability and experience continue to be the most crucial factors, and use of proven technologies is safest for patients.