An estimated 2-to-4% of the U.S. population will need a knee replacement at some point in their lives — usually after the age of 50. “By the time patients come to us, they’ve usually unsuccessfully tried a multitude of options short of surgery — including anti-inflammatory medications, injections, braces and physical therapy — and their quality of life has suffered,” says Erik Zeegen, MD, chief of joint-replacement surgery at UCLA. “With a knee replacement, many of these individuals are free from pain and can resume an active lifestyle, which has both psychological and cardiovascular benefits.” Nationally, approximately 15% of patients who undergo conventional knee-replacement surgery report being dissatisfied with the result, even when X-rays indicate that the surgery was successful, either because of residual pain or instability, Dr. Zeegen notes. “The robot helps decrease the variability in alignment of the prosthesis and allows us to measure precisely how tight or loose the knee is on one side versus the other,” he says.
“Traditionally, we have relied on visual and bony landmarks, which are inexact,” says Alexandra Stavrakis, MD, a UCLA jointreplacement surgeon. “Using the robot minimizes the likelihood of the implants not being placed at an ideal angle.”
Although robotic-assisted knee-replacement surgery is too new for there to be studies with long-term outcomes, Dr. Zeegen says that in addition to the postsurgical X-ray results indicating improved consistency and accuracy in the alignment of the new knee, he and Dr. Stavrakis have noted improved patient satisfaction with the outcomes. “I’ve seen patients who had a conventional knee replacement and then had their other knee replaced with the robotic-assisted technique,” Dr. Zeegen says. “They report that the second knee feels better, and that their recovery was quicker.” Robotic technology has become commonplace in many surgical settings, Dr. Stavrakis notes. It has been used for nearly a decade in partial-knee-replacement procedures and was recently approved by the U.S. Food and Drug Administration for complete knee replacement. For the procedure, surgeons create a three-dimensional model of the knee, which they then use to plan the surgery on the computer screen, with the robot executing the cuts while under the surgeon’s control.
“We see patients who have waited too long,” Dr. Zeegen says. “If left untreated, the arthritic knee can become contracted and the knee can lose significant range of motion, as well as experience deterioration of the bone. This makes the surgery and recovery much more challenging.
“In the past, many patients have been hesitant about surgery, but with the improvements associated with robotic-assisted knee replacement, we have the confidence to report that we’re seeing more satisfied outcomes,” he says.