Orthopaedics Sports Medicine and Podiatry

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Sports Medicine & Orthopaedics Blog

Sports Medicine & Orthopaedics Questions and Answers

Computer assisted and robotic joint replacement are the latest marketing scheme used by joint companies and hospitals to attract patients.  These techniques could prove to be successful in the future, however, there is no evidence that there are improved results or decreased complications using these techniques.  Of more importance is the track record of the prostheses themselves. With new prostheses, there is often little history to gauge longevity of the joint or the risk of complication.  In my experience, there is no advantage yet to computer assistance.  This requires that markers be placed near the joint being replaced attached to the bone using screwed in pins.  These markers are seen by a device which can calculate joint position and alignment using these markers.  This may easily introduce error if a pin is bumped during surgery with a small change in position magnified by the difference between the length between the half pin and the center axis of the limb compared to the distance from the joint to the floor (as in the case of a knee replacement).  This means that accidentally bumping a pin during surgery can have a dramatic affect on proper alignment and placement.  In addition, the normal means of alignment is not used. This makes the alignment more dependent on the computer and essentially less dependent on the surgeon.  In addition, computer assisted implantation is more expensive and takes more time.  The decision to use standard techniques or computer assisted implantation should be discussed with your surgeon.  Remember that the latest technique may eventually be shown to be the best, but you do not want to be part of a test group with failures.   

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