The total knee arthroplasty (TKA) has continuously evolved over the past decades. One of the latest innovations is the use of robotic systems in the implantation of knee prostheses. Robotic-assisted surgery promises more precise placement of prosthetics, faster rehabilitation, and longer durability of the implants. But why will this technology be the standard method in the future? In this comprehensive article, we will discuss the most important aspects of robotic-assisted TKA, analyze current developments, and show why robots are the future of knee arthroplasty.

1. Basics of Total Knee Replacement

Total knee arthroplasty is a proven method for treating severe knee joint diseases such as osteoarthritis, rheumatoid arthritis, or traumatic knee injuries. The damaged joint is replaced with an artificial prosthesis to alleviate pain and improve the patient's mobility.

1.1 When is a knee replacement necessary?

• Advanced knee osteoarthritis with severe pain
• Movement restrictions that complicate daily life
• Misalignment of the knee joint
• Failure of conservative therapies (physiotherapy, pain medication, injections)

1.2 Procedure of a Knee Prosthesis Operation

• Preparation: Imaging procedures for precise planning
• Removal of damaged joint cartilage
• Adjustment of bone structure
• Insertion of the knee prosthesis
• Fixation and control of stability

2. The role of robotics in knee surgery

2.1 What is a robot-assisted knee TEP?

The robot-assisted TKR (Total Knee Replacement) uses computer-assisted systems to perform the operation with the highest precision. A robotic system is used to help the surgeon position the implant optimally. This potentially reduces the risk of human error and improves the long-term results of the operation.

2.2 Which robots are currently in use?

• MAKO Robotic-Arm Assisted Surgery: This system supports the surgeon with data from a preoperative CT and real-time feedback during the operation.
• NAVIO Surgical System: A robotic platform that dispenses with prior CT scans and uses intraoperative imaging.
• ROSA Knee System: Developed by Zimmer Biomet, this system combines artificial intelligence with surgical precision.
• CORI Surgical System: A compact, portable robotic solution for minimally invasive knee TEP.
• MISSO Robotic System: The first system with fully automated bone preparation from the company Meril. Here too, CT data is used, it is a image-guided robotics.

2.3 Potential benefits of robotics in knee TEP implantation

• More precise implant placement: Through millimeter-accurate planning and implementation, the implant can be ideally aligned.
• Reduced risk of complications: Precise cuts lead to less tissue trauma and lower infection rates.
• Less blood loss and fewer soft tissue damages: Gentler surgical methods mean faster healing.
• Faster rehabilitation and better long-term results: Patients regain their mobility more quickly.

3. Why will robotics become the standard in the future?

3.1 Advances in Medical Technology

• Improved sensor technologies enable precise navigation during the procedure.
• Artificial intelligence supports the surgeon with real-time analyses.
• Optimized planning methods ensure individual patient adjustments.

3.2 Potential Long-term Benefits for Patients

• Longer durability of implants: Less wear and tear due to precise placement.
• Fewer revision surgeries required: Lower error rate reduces follow-up operations.
• Higher patient satisfaction: Improved functionality and natural movement feeling.

3.3 Long-term cost efficiency

Although the acquisition costs for robots are high, the reduction of complications and faster healing lead to lower healthcare costs in the long term.

4. Challenges and limitations of knee robots

4.1 High acquisition costs for hospitals

• Investment in expensive robotic technology.
• Need for special operating rooms and maintenance costs.

4.2 Need for specialized surgeons

• Longer training periods for surgeons.
• Ongoing training required.

4.3 Technical Risks

• Possible system failures or software problems.
• Need for a backup strategy for emergencies.

5. Future outlook: Where is the journey headed for robotics in endoprosthetics?

5.1 Development of autonomous robotic systems

• Self-learning algorithms for maximum precision.
• Real-time corrections to optimize surgical results.

5.2 Combination with other technologies

• Augmented reality for improved visualization.
• 3D printing for individually customized implants.

5.3 Individualized patient treatment

• Motion analyses for optimal implant selection.
• Patient-specific surgical planning for perfect fit.

6. Conclusion: Robots for a knee prosthesis (knee TEP) will become the norm in the future

The robot-assisted knee TEP will establish itself as a standard in the future due to its superior precision, lower complication rate, and better long-term results. While there are still challenges at present, the long-term benefits for both patients and the healthcare system are undeniable. With further advances in medical technology, robotics in knee surgery will become an indispensable method.