captured during pre-op CT scans of the knee joint. The scans are
loaded into the robotic platform's computing system, which plots
placement of the ideal cuts based on the patient's specific anatomy.
During surgery, the computer guides surgeons to where the cuts
should be made. "That means surgeons don't undercut or cut more
than they should," says Dr. Stearns.
With the robot's navigation system guiding the surgeon's hand, he's
able to make precise cuts in the bone and match placement of the
implant to the overall alignment of the leg in a more anatomically
exact way. In theory, the more precise cuts afforded by robotic assis-
tance lead to better short-term outcomes and improved long-term
durability of the implant. Although ongoing research is attempting to
definitely confirm those clinical benefits.
The technology does add several minutes to case set-up times as
surgeons register anatomical landmarks around the entire knee joint,
including the femur and tibia, to inform the navigation system where
in space the bones are located.
Surgeons who operate with the robot also tend to go slower, accord-
ing to Dr. Stearns, who says a few extra minutes of operative time is
worth the wait. "The trade-off is you get more anatomic and more
exact bone cuts, and a joint that is better balanced and in better align-
ment," he says.
Robotic-assistance also lets surgeons perform minimally invasive
knee replacements that limit tissue damage and blood loss, according
to Joseph Bosco, MD, a professor and vice chair in the department of
orthopedic surgery at NYU Langone Health in New York, N.Y. He says
the pre-op planning that's required to perform robotic surgeries elimi-
nates the recuts and implant manipulation that often occur during
manual knee placements and that result in additional blood loss and
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