Robotic Surgical Systems for Orthopedics

Key Messages

• Robotic surgical systems for orthopedics are used primarily in procedures to treat osteoarthritis (either partial or full knee replacement or total hip replacement), and in procedures to treat degenerative spinal disease or spinal alignment or curvature abnormalities. Robotic-assisted orthopedic surgeries are intended to improve the accuracy and precision of implant placement and may lead to improved clinical outcomes, shorter recovery time, and fewer revisions. Evidence around their clinical effectiveness is still limited, however, the trend suggests that robot-assisted surgeries may be comparable, or marginally better, in clinical effectiveness when compared to conventional techniques. Robotic-assisted surgery can reduce the length of inpatient stay, but it involves longer operative times. Larger, long-term, randomized controlled trials are needed to confirm their comparative effectiveness.
• Robotic surgical systems for orthopedics are costly because their initial capital purchase is high, and each procedure requires the use of consumables. However, they may reduce length of stay, which can free up inpatient beds, and reduce rates of revision, which can be cost saving. While some evidence suggests that robotic-assisted knee and hip replacements can be cost-effective, there is limited cost-effectiveness information specific to Canadian contexts.
• There is a steep learning curve to adopting robotic surgical systems and teams require training and ongoing technical support to ensure that the unit is used to its full capacity. The roles of team members, particularly nursing staff, may change and require advanced technical knowledge.
• Robotic surgical systems are constantly evolving, integrating new and improved components such as augmented reality, artificial intelligence, digital imaging, and computer-assisted navigation. There will likely be many changes and refinements to these technologies over the coming years.