Computer Assisted Joint Replacement FAQs

What are the other synonyms for computer-assisted surgery?
“Computer-assisted” surgery is also called “computer-integrated surgery”, “computer-aided surgery”, “image-guided surgery” or “surgical navigation”.
Why do surgeons use computer-guided surgery?
The literature has shown that improving the alignment and precision in placement of total knee components and total hip components will improve the longevity of joints.  Therefore, with the use of computer guidance, it is possible to improve the accuracy and placement of components and surgeons therefore use computer-assisted technology for improving the precision of placement of components.
What are the disadvantages of computer-assisted surgery?
Computer-assisted surgery increases the cost of the surgical procedure.  In addition, there are unique complications associated with computer-assisted surgery including increased surgical time. Additionally, if pins are used in the bone, pins can cause stress fractures in the bone and make the bone prone to fracturing.

There is a risk of infection in these pin sites.  This infection can travel to the joints. It is important to be cognizant of these complications when the surgeon uses computer-assisted technology.

When do you use computer-assisted technology?
I use a navigation for extraarticular deformities, which means that there are deformities in the bone above or below the knee joint.  These deformities make the manual surgical planning difficult.  Additionally if the patient has implants like intramedullary implant in the femoral or in the tibia, it is not possible to place guides into the bones and I tend to use the computer-assisted navigation in these cases.

One major advantage of computer-assisted technology is that the femoral canal and the tibial canal does not need to be drilled while doing the procedure. This makes the surgery less invasive and also is responsible for less blood loss in the surgery and after the surgery.

What are the advantages of computer-assisted technology?
The advantages of computer-assisted technology are improved precision in the placement of implants of hip and the knee.  There is also an advantage of not violating the intramedullary canal, which makes the surgery less invasive.  Better accuracy and precise placement of the components will help improve the long-term results of joint replacement surgery.
How is robotic knee replacement surgery different from computer-assisted navigation?
Robotic hip and knee replacement surgery is taking the computer-assisted technology further in which the surgeon’s hand is guided by a robot.  There are certain tolerances, which are allowed by the robot and the surgeon is ultimately making the decisions.  These technologies are “semi-active” technologies, which implies that the surgeon as well as the robot both are doing the work on the bone.

The earlier robotic technologies which were active were not very precise and were associated with increased risk of complications.  Today’s technologies allow the surgeon to optimally use the technology to improve the outcome of the patients.

What type of imaging is needed for image-based computer-assisted navigation and robotic technology?
Preoperative CT scan is needed for preoperative planning of knee arthroplasty.