Clin Orthop Surg.  2014 Dec;6(4):462-467. 10.4055/cios.2014.6.4.462.

Robotic and Navigation Systems in Orthopaedic Surgery: How Much Do Our Patients Understand?

• Jassim SS
• Benjamin-Laing H
• Douglas SL
• Haddad FS

• KMID: 1794736
• DOI: http://doi.org/10.4055/cios.2014.6.4.462

Abstract

BACKGROUND
Technology in orthopaedic surgery has become more widespread in the past 20 years, with emerging evidence of its benefits in arthroplasty. Although patients are aware of benefits of conventional joint replacement, little is known on patients' knowledge of the prevalence, benefits or drawbacks of surgery involving navigation or robotic systems.
METHODS
In an outpatient arthroplasty clinic, 100 consecutive patients were approached and given questionnaires to assess their knowledge of navigation and robotics in orthopaedic surgery. Participation in the survey was voluntary.
RESULTS
Ninety-eight patients volunteered to participate in the survey, mean age 56.2 years (range, 19 to 88 years; 52 female, 46 male). Forty percent of patients thought more than 30% of National Health Service (NHS) orthopaedic operations involved navigation or robotics; 80% believed this was the same level or less than the private sector. One-third believed most of an operation could be performed independently by a robotic/navigation system. Amongst perceived benefits of navigation/robotic surgery was more accurate surgery (47%), quicker surgery (50%), and making the surgeon's job easier (52%). Sixty-nine percent believed navigation/robotics was more expensive and 20% believed it held no benefit against conventional surgery, with only 9% believing it led to longer surgery. Almost 50% would not mind at least some of their operation being performed with use of robotics/navigation.
CONCLUSIONS
Although few patients were familiar with this new technology, there appeared to be a strong consensus it was quicker and more accurate than conventional surgery. Many patients appear to believe navigation and robotics in orthopaedic surgery is largely the preserve of the private sector. This study demonstrates public knowledge of such new technologies is limited and a need to inform patients of the relative merits and drawbacks of such surgery prior to their more widespread implementation.

Keyword

Robotics; Navigation; Arthroplasty; Patients; Survey

MeSH Terms

Adult
Aged
Aged, 80 and over
*Comprehension
Cross-Sectional Studies
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Orthopedic Procedures/*psychology
Questionnaires
Robotic Surgical Procedures/psychology
Surgery, Computer-Assisted/*psychology
Young Adult

Figure

• 

  Fig. 1 Pie chart of Question 1 responses: How much of an operation do you think can be independently performed by a robot or with navigation? Sixty-four percent believe some of an operation can be performed independently; 33% replied 'most' and 3% stated 'all.'

• 

  Fig. 2 Bar chart of Question 2 responses: Can you estimate what percentage of orthopaedic operations in the National Health Service (NHS) currently use robotics or navigation? Twenty-five percent estimated less than 10% whilst 75% estimated at least 10%. Seventeen percent believed that more than half of NHS operations used robotics or navigation.

• 

  Fig. 3 Pie chart of Question 3 responses: How do you think use of robotics and navigation in National Health Service (NHS) compares to use in the private sector? Nineteen percent believed that more was done in the NHS, 35% believed it was the same as in the private sector and 46% believed that more operations involving robotics and navigation were done in the private sector.

• 

  Fig. 4 Bar chart of Question 4 responses: What sort of benefits do you think robots and navigation may have for surgery (compared to conventional surgery)? At least 50% of responders believed that surgery involving robotics and navigation was quicker and easier for the surgeon compared to conventional surgery. Forty-seven percent believed it was more accurate and 30% believed it has fewer complications compared to conventional surgery.

• 

  Fig. 5 Bar chart of Question 5 responses: What sort of drawbacks do you think robotics and navigation may have for surgery (compared to conventional surgery)? Sixty-nine percent believed it was more expensive compared to conventional surgery. Nine percent thought it took longer and 20% believed there was not much benefit over conventional methods.

• 

  Fig. 6 Pie chart of Question 6 responses: Do you think you would like to have your operation done using robotics or navigation? Eighteen percent would not like their surgery to involve robotics or navigation. Thirty-five percent were not sure and 47% would not mind at least some of their operation to involve robotics and navigation.

Reference

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