Computer-assisted and robotic surgery in orthopedics: where we are in 2014

Area of Science:

• Orthopedic Surgery
• Surgical Navigation Technology

Background:

• Reproducible anatomic accuracy is crucial for successful orthopedic surgical outcomes.
• Intraoperative feedback, such as fluoroscopy, aids surgeons in achieving accuracy.
• Computer navigation and robotic assistance are increasingly used in various orthopedic procedures.

Purpose of the Study:

• To evaluate the accuracy and clinical outcomes of non-image-based computer navigation and robotic-assisted surgery in orthopedics.
• To compare these advanced technologies with conventional surgical techniques.
• To analyze the cost-effectiveness and impact on surgeon experience.

Main Methods:

• Review of studies utilizing non-image-based computer navigation in joint arthroplasty, ligament reconstruction, osteotomy, cartilage procedures, and arthroscopy.
• Analysis of robotic-assisted surgery applications, primarily in total and unicompartmental arthroplasty.
• Comparison of accuracy and clinical outcomes between advanced technologies and conventional methods.

Main Results:

• Non-image-based computer navigation and robotic-assisted surgery demonstrate superior accuracy compared to conventional techniques in the short term.
• Clinical outcomes are often similar between advanced technologies and conventional methods.
• High-cost technologies may be cost-effective in high-volume centers.
• Computer navigation significantly improves accuracy for lower-volume surgeons, bringing their results to par with higher-volume surgeons.

Conclusions:

• Advanced surgical technologies like computer navigation and robotics enhance precision in orthopedic surgery.
• While accuracy is improved, translation to better clinical outcomes requires further investigation.
• Cost-effectiveness is a significant consideration, particularly in relation to surgical volume and surgeon experience.