A robotic assistant for joint replacement surgery

According to Dr Chua, the robotic arm is only semi-active and still requires the surgeon to make the final decisions during the operation. — Sunway Medical Centre

Are you one of the millions of silent sufferers living with chronic pain caused by arthritis or an injury to the hip or knee?

While conservative treatment options are the first line of treatment, some patients with severe disease may require hip or knee replacement surgery.

While we’re more used to human surgeons wielding the scalpel, nowadays, such surgery can be done with the help of robotic technology.

In Malaysia, over 300 patients have undergone robotic arm- assisted knee or hip replacement surgery since its introduction here in recent years.

Consultant orthopaedic, joint and arthroplasty surgeon Dr Chua Hwa Sen shares that the popularity of robotic arm-assisted knee and hip replacement surgeries is growing due to its ability to provide each patient with a surgical experience that is specifically tailored to the individual’s needs and anatomy.

With the new technology, he says surgeons are able to facilitate more accurate placement of implants, while being minimally invasive in cutting the patient.

This allows patients to experience less post-operative pain and recover faster.

He explains: “Treatment begins with CT-based 3D modelling to help surgeons view in detail each patient’s diseased anatomy prior to surgery to formulate a personalised surgical plan.

“Given that every joint is different – even more so for diseased joints, as the degree of severity varies greatly in different patients – the robot (along with pre-operative CT scans and 3D reconstruction) greatly helps surgeons plan accurately for each patient.

“The robot intraoperatively helps surgeons to seek the most ideal position and size of new joints for the patients, as well as accurately resect the bones and implant the new joints.”

Interest among the surgical community in this procedure is also increasing, with more and more surgeons showing interest in being trained for these procedures.

They merely assist

Dr Chua also assures that the robot is not doing the entire surgery and is merely assisting with the operation.

“People often think that surgeons sit back and relax when the surgery is being conducted by the robot.

“That is not true.

“The robot is a semi-active robot. Hence, the procedure is called robotic arm-assisted joint replacement.

“The surgeon is there every step of the way to expose the joints, release soft tissues, feed live movement of the joints to the robots intraoperatively to have wider combinations of data.”

He explains that the robot’s function during surgery is to enable surgeons to be precise in determining the best placement of implants within the joint.

The robot can accurately feed back data that is impossible to be detected with the naked eyes, he says, adding that it can adjust bone cuts and the degree of joint rotation as precisely as 0.1mm and 0.5 degrees respectively.

“Accuracy makes the surgery less invasive and enables us to sacrifice less healthy bone and tissues.

“‘The more we see, the more you keep’ is the key message of CT- based 3D modelling robotic arm-assisted joint replacement to our patients.”

Dr Chua notes that the robot’s accuracy reduces post-operative pain greatly, reduces the need for physical therapy, helps patients accept new joints with less effort, achieves a much better outcome, and potentially increases the longevity of the new implants.

Urging the public to be more open to technological advancements, he says the rise of robotics and artificial intelligence in healthcare is beneficial to society and should be embraced.

“Instead of being wary of it, let it assist us and improve our quality of life.”