tainly increases the likelihood that surgeons place implants precisely
as planned.
It's my belief that robotics will eventually be the great equalizer in
joint replacement surgery. Any reasonably gifted community surgeon,
even if he does only 20 or 30 joint replacements a year, will be able to
incorporate robotics into his practice to achieve outcomes at the high-
est possible level.
2. Patient-specific instruments
Patient-specific instruments (PSIs) are custom tools that are specifi-
cally crafted for each individual patient with the use of 3D printing
technology. Ideally, surgeons can use PSIs to facilitate the proper and
accurate placement of implants. However, one of the limitations of
using PSIs is losing predictability of the surgical outcome if a cutting
guide or tool does not completely match the bone model. Clinical
researchers have shown that PSIs are powerful tools in the hands of
skilled and experienced surgeons, but surgeons who perform few
cases with this technology might not be able to achieve proper out-
comes and may report that the technology does not improve their
accuracy.
3. Customized knee systems
Custom designed knee systems are created by using casting or
milling (3D printing will be available in the near future) to create
implants that fit an individual patient's anatomy. Some patients with
customized implants have done exceptionally well, and sometimes
better, than those who receive off-the-shelf implants. Ideally, sur-
geons would be able to pair robotics with customized implants.
Combining these technologies would allow the high precision of the
robot to benefit fully from an implant that is a perfect match to the
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