Robotic technologies are used more widely in the world with each passing day. In parallel with the developments in technology, robots are widely used in medicine. In parallel with these developments, robotic technology has started to gain a place the field of orthopedics, as well. The number of orthopedic surgical operations performed using robotic technology is increasing day by day. Robotic technology is used in hip and knee joint replacement surgeries in the field of orthopedics. It is expected to be used in tumor removal, shoulder, and spine surgeries in the near future.

Robotic surgery involves auxiliary systems used in knee or hip replacement surgeries. The operation is planned, the patient’s data are evaluated, and the operation is performed with the help of robotic systems under the control of the surgeon. As even an experienced orthopedic surgeon is likely to adjust implant positions with a certain margin of error, new innovations have been sought. The most important features of Robotic Surgery include that the bone incisions planned to be made in the surgery are designed preoperatively in the computer environment, component positions are adjusted optimally, and bone incisions are made flawlessly with the help of a robotic arm. Thanks to positioning the implant optimally, implants lasts longer and they wear and loosen after a longer period of time. The entire procedure is performed by your physician. Robotic surgery requires special training and certification.

What is Robotic Arm Interactive Orthopedics System?

Today, there are systems for robotic or navigation surgery produced by several companies. Most of these systems just use the navigation feature. Navigation systems play a guiding role for the surgeon. The navigation system and the robotic arm interactive orthopedic system are not the same thing. The robotic system has both a guiding system and a robotic arm system that limit the margin of error to millimetric ranges during surgery. In our clinic, we use the MAKO Robotic System developed by Stryker as a Robotic Arm Interactive Orthopedics System. The MAKO system has not only be equipped with a navigation system, but also a special robotic arm developed to ensure correct bone incisions. “Robotic Arm Interactive Orthopedics System consists of three main units including a computerized control and guidance module, a camera and a display stand. Thanks to this system, the physician can make a patient-specific plan and perform the surgery accordingly. During surgery, the robotic arm guides the surgeon to ensure correct preparation and placement of the implant sockets. The special robotic arm (Picture 1), which is not available in other systems, ensures correct bone incisions during surgery. Another very important advantage of this system that is not available in other systems is the ability to minimize the risk of hip implant dislocation, especially in cases of hip implant placement because its evaluation process also includes the waist region.

Figure 1: The view of the robotic arm used in hip and knee replacement.

Important advantages of the robotic arm Interactive Orthopedics system

• A 3-dimensional analysis of the patient’s joint structure is conducted using the computed tomography images of the patients’ joints, and then a patient-specific surgical plan is made accordingly. This prevents unnecessary bone incisions and tissue damages.
• The ability to make a patient-specific implant placement plan ensures soft tissue balance and stability as well as a joint balance suitable for the patient.
• With the support of the robotic arm, the Haptic Feedback provided to the surgeon during the surgery when he or she touches the relevant bone areas reveals the patient’s joint shape. This enables the surgeon to interactively control the data throughout the surgery, ensuring zero-error bone incisions.