Health Essentials from Cleveland Clinic

The idea of a robot performing surgery may seem like something from a science fiction film, but robots are an increasingly common sight in surgical suites. When it comes to certain types of joint replacement surgeries, robots can help improve accuracy — which can mean better outcomes for patients.

If you’re facing surgery, you might be wondering if robotic-assisted surgery is appropriate for only certain patients. But anyone is a good candidate, says orthopedic surgeon Robert Molloy, MD. If you’re a good candidate for joint replacement surgery in general, robotic joint replacement is for you.

“It’s a technology that’s not limited to any particular type of patient,” he says.

Surgeons currently are using robotic technology for partial knee replacements, full knee replacements and hip replacements, he says.

How robotic-assisted surgery works

The robots don’t operate on their own, of course. What they’re actually doing is helping surgeons do their jobs more precisely.

• The robots help with pre-surgical planning. Using 3-D imaging, doctors can plan each surgery around the patient’s unique anatomy. This helps to ensure the correct sizing and positioning of the implant.
• The robotic arm controls certain aspects of the surgery. “The robotic arm positions the saw blade for a total knee replacement or the reamer for a total hip replacement,” Dr. Molloy says. “The arm positions the tool so that it can only operate in one plane, so it’s very precise. The robotic arm won’t allow the surgeon to go outside the specified dimensions.”

Is robotic really better?

A growing body of evidence suggests that robotic joint surgery offers advantages over non-robotic procedures. However, the data isn’t in yet for all types of joint replacements.

Surgeons have been using robots in partial knee replacements for a longer time, Dr. Molloy says. “There is data to suggest that there are fewer failures of robotic partial knee replacements than there are of standard partial knee replacements,” he says.

The technology has only recently been adapted for use in total knee replacements and hip replacements, but Dr. Molloy is optimistic.

“We don’t have any data yet to know if it improves outcomes, but we know it improves accuracy,” he says. “We are hopeful that that improvement in accuracy will lead to better outcomes.”

Potential for faster recovery

Robotic-assisted surgery has the potential to speed recovery compared to standard procedures, Dr. Molloy says. It also allows a more customized, individually tailored approach.

“What the robot allows us to do is to take into account the patient’s own anatomy, their soft tissue structure, and customize the surgery for them,” he says. “For someone who’s really bowlegged, we might leave them just a little bowlegged. That allows us to put the knee in in a way that’s more friendly to their soft tissue.”

With the ability to customize joint replacement surgeries for each patient’s individual anatomy, robotic-assisted procedures offer hope for more successful hip and knee replacements, Dr. Molloy says.