Robotic Joint Replacement

A emerging practice in the field of joint replacement is the use of robotic technologies to assist the surgeon in the joint replacement. These are predominantly used in partial and total knee replacements, and computer navigation is used predominantly with total hip replacement. For total knees, Dr. Mosher is happy to use this technology if a patient requests. For total hips, he will use computer navigation as a standard measure.

The goal of robotic assistance with partial and total knee replacement is to limit soft tissue dissection at the joint line, and do a majority of the correction with saw cuts—which are based on intraoperative registration and sometimes even a preoperative CT scan. There are multiple robots available for use, and each major implant company has their own. Dr. Mosher is trained specifically for their use in this area. Notably, Dr. Mosher will still be doing the surgery, but the robotic arm and associated computer program will be assisting with guiding the saw cuts.

Notably, the use of robotic technology with total knee arthroplasty requires the usage of pins either inside or outside the incision in both the tibia and the femur. This does introduce the small, but present, unique risk of fracture at the pin site after surgery. No research has shown any definite benefit to patient outcomes after use of robotic assistance vs. conventional instrumentation. However, some studies have hinted to decreased early postoperative pain, better early range of motion, and possibly lower revision rate—though many of these studies are also loosely funded by robotic implant manufacturers.

For total hip arthroplasty, no arm will be used, but computer navigation will be used with fluoroscopy to confirm that the components are in appropriate position with acceptable restoration of limb length and offset.

For specific questions, Dr. Mosher will speak to you in clinic at one of the convienent Decatur, Madison, or Huntsville locations prior to surgery scheduling. He can also speak with you via telehealth, if you have a long commute.

AAHKS video regarding robotic and computer navigation in joint replacement surgery (Link)