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the surgeon to precisely
prepare the bone surface
and accurately place and
align the implant. Patient
benefits of using robotic
technology for partial
knee replacement can
include less bone
removal, improved surgi-
cal accuracy and optimal
implant positioning.
"It's a technology I think
you'll see more and more of, since unicompartmental knee replacements are
now being done frequently in surgery centers," says David Geier, MD, a sports
medicine specialist and orthopedic surgeon based in Charleston, S.C.
• Custom cutting guides.
The end result here is a 3D printout of a custom jig —
a plastic cutting guide — that directs the surgeon's incisions. After you make
the incision, you put the prefabricated, customized cutting block on the ends of
the femur and tibia to help the surgeon position the knee components. All plan-
ning and sizing takes place pre-operatively with technology that produces
patient-specific instruments. The printout is made based on an extremity MRI
or CAT scan. "This is a real time saver in surgery," says Dr. Peters, who has
used custom jigs in about 15 cases. "It also takes some of the uncertainty out of
your cuts because you've used a computer to align the leg and design your cuts
exactly how you want them instead of relying on some standard angle cuts."
A report in the September 2013 Journal of the American Academy of
Orthopaedic Surgeons observes that "the use of patient-specific instruments for
total knee arthroplasty shifts computer navigation for bone landmark registra-
tion and implant positioning from the intraoperative to the pre-operative set-
ting."
S U R G I C A L N A V I G A T I O N
ROBOTICS David Geier, MD, a sports
medicine specialist and orthopedic sur-
geon based in Charleston, S.C., examines
a handheld robotic arm system.
