Robotic Assisted Total Knee Arthroplasty

Abstract

Total Knee Arthroplasty (TKA) is considered the gold standard of treatment for patients with severe knee arthrosis who failed conservative treatment. Conventional TKA is generally accepted as the standard technique which shows excellent long-term result. Whereas, robotic assisted TKA, has become an interesting technique recently. Main goal of robotic assisted TKA is to minimize human errors in surgical technique. Theoretically advantages are ability to plan the size and position of implants based on preoperative imaging and by assisting surgeons to more precisely and more accurately prepare the bone, minimized soft tissue injury, the physiological kinematics of the joint and the overall alignment of lower limb are also better restored. In this article, we demonstrate basic principles, basic instruments and summarize basic steps of robotic assisted TKA into four main steps; preoperative imaging process, bone registration process, preoperative planning process and bone cutting process. We review various robotic systems and categorize into different groups base on requirements of preoperative imaging usage and level of interaction of the surgeon in operations. The different robotic systems were subdivided into image-based/imageless and active/passive/ semi-active. We also report outcomes of this technology from literatures reviews.