Robotic-Assisted Orthopaedic Surgery: Is It Beneficial?

So far, an enormous amount of money has been spent on equipment to improve the accuracy of a cut when installing joints for knee and hip replacement. Computer navigation, however, has not been proven to show any overall benefit to the patient, i.e., no effect on pain, the quality of the implant, patient satisfaction, etc.  However, equipment is very expensive.  It adds an enormous amount of time to the surgery and therefore increases the cost of the procedures.

There is a tendency for orthopaedists to be the first one on the block with a new technique or the first with a new product for the benefit of their patient.  Unfortunately, this occurs whether or not it has been supported by sufficient research and before adequate data has been scrutinized.  This often leads to acceptance of techniques that later have to be discarded because better research with longer-term followup proves them to be either worthless or even harmful.  An example of this is thermocapsular shrinkage in the shoulder- a disaster!

Louis Bigliani, M.D., et al., in the Journal of Arthroplasty, February 2021, published results of a study using online crowdsourcing for public perception of robotic-assisted orthopaedic procedures.  A 30-question survey completed by 580 members of the public believe that robotic-assisted surgery gives better results 69% of the time with less pain 59% of the time and less complications 69% of the time  as well as faster recovery 63% of the time.  None of this is actually true.  One of the main concerns the public  had was lack of surgeon experience and robotic malfunction which could cause harm and increase costs.  Overall, 34% of the participants in a survey had a clear preference for robotic-assisted surgery over conventional surgery.

When confronted with a new technique or technology, you need make sure that the doctor can support it with research data and personal experience.  Robotic-assisted knee replacement is being promoted by some surgeons in Nebraska.  This is marketing adds great cost and no added benefit!  Those of use who really know what is going on and are looking out for our patients do not need to be grasping straws to draw in business.  Traditional technique is the solid foundation.  So far, robotics and navigation have not proven beneficial in extremity surgery.