J Korean Orthop Assoc.  2018 Dec;53(6):459-465. 10.4055/jkoa.2018.53.6.459.

Robotic Surgery in the Orthopedic Field

• Lee WS
• Jung WS

• KMID: 2430052
• DOI: http://doi.org/10.4055/jkoa.2018.53.6.459

Abstract

Of the many factors that affect the clinical outcomes of orthopedic surgery, the surgical procedure is the most important. Robotics have been developed to perform the surgical procedures more accurately and consistently. Robotic surgical procedures in the orthopedic field were developed 20 years ago. Some designs of surgical robots have disappeared due to practical problems and complications, and an another design of surgical robots is emerging. To date, the use of robot surgery in arthroplasty is still controversial in terms of the clinical outcomes, practicality, and cost-effectiveness, even though it has been reported to be effective in the alignment and positioning of components in the field of artificial joints. Early robotic surgery was based mainly on active robot surgery according to the scheduled operation without the intervention of the operator. Recently the semi-active system of robotic surgery has been introduced. In a semi-active system, the robot constrains the surgeon to a haptic boundary defined by the computer based on the 3-dimensional imaging preoperative plan, and the operator can change the preoperative plan through real-time feedback during operation.

Keyword

robotics; robotic surgical procedure; orthopedic

MeSH Terms

Arthroplasty
Joints
Orthopedics*
Robotic Surgical Procedures
Robotics

Figure

• 

  Figure 1 A 3-dimensional model is loaded into the robotic system software and used to develop a preoperative plan for robotic total knee arthroplasty. This allows the surgeon to preoperatively template both the bone cuts and implant size and position to be used in surgery.

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  Figure 2 Bone registration and verification of both the femoral and tibial surfaces is performed for setting the anteroposterior, medial/lateral, proximal/distal directions, and axial rotation alignment of each bone.

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  Figure 3 The bone for the implant is prepared by the robotic-arm based on preoperative plan. A saw blade is employed by the robotic arm to remove bone within a haptic boundary, which is under direct surgeon control and gives tactile feedback.

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