A Detailed analysis of Time taken in Robotic Surgery for Total Knee Replacement Arthroplasty and comparison with computer assisted navigation in Total Knee Replacement Arthroplasty

3 pages•Published: September 25, 2020

Abstract

The accuracy of implantation using computer navigation and robotic total knee replacement (TKR) has been proven. Time taken during surgery has been a factor for surgeons for not using the technology. Aim of this study was to analyse time taken in different steps and identify which part needs improvement. Robotic time was compared to computer navigation. Methods: 15TKR were performed with MAKO robot. Software for the ligament balancing was used. All had CT scan preoperatively. Time of different surgical steps was recorded. Time for computer navigation was recorded too. After joint exposure, trackers and verification pins for tibia and femur were inserted. Femoral registration matching started at 10.8 minutes (SD3.3 Range7-20). It took 3.2 minutes to match femoral anatomy to CT scan. Tibial registration done at 14.1minutes (SD3 Range10- 23). Once matching was accepted to required accuracy, tibial cut was made at 22.2 minutes (SD4.4 Range 15-30). Next the soft tissues were assessed with tensioner. It took 6.3 minutes (SD 5.6). Final femoral preparation done at 35.7 minutes (SD 5.6 Range25-45). Trial performed at 52 minutes (SD7.3 Range42-63). Implants were cemented at 63.4 minutes (SD8 Range50-72). Wound closed at 77.6 minutes (SD9.5 Range65-97). The computer navigated TKR surgery took 70 minutes on an average. Compared to navigation, robotic technique took approximately 7 minutes longer, not significantly different. This could be due to learning curve of the surgical and theatre team. Improvement is required in different steps. The familiarity of staff will increase the efficiency. Registration matching took 11.4 minutes. Femoral preparation took 17 minutes. These steps could be streamlined.

Keyphrases: mako, performance, robotic, time, total knee replacement

In: Ferdinando Rodriguez Y Baena and Fabio Tatti (editors). CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 4, pages 56-58.

Links:	https://easychair.org/publications/paper/jm1R
	https://doi.org/10.29007/65qr

BibTeX entry

@inproceedings{CAOS2020:Detailed_analysis_Time_taken,
  author    = {Kamal Deep and Frederic Picard},
  title     = {A Detailed analysis of Time taken in Robotic Surgery for Total Knee Replacement Arthroplasty and comparison with computer assisted navigation in Total Knee Replacement Arthroplasty},
  booktitle = {CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Ferdinando Rodriguez Y Baena and Fabio Tatti},
  series    = {EPiC Series in Health Sciences},
  volume    = {4},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/jm1R},
  doi       = {10.29007/65qr},
  pages     = {56-58},
  year      = {2020}}

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