Surgical: Note: This video contains graphic surgical footage so viewer discretion is advised. Director of the Penn Orthopaedics Robotics and Navigation Program, Dr. Christopher Travers, discusses robotic joint replacement surgery, which is one of the multiple options that Penn Orthopaedics offers for joint replacement surgery. He walks through a robotic knee replacement surgery, discussing what the procedure is, how it differs from traditional joint replacement surgery, and the benefits. Refer a patient (physicians only) Learn more about the Penn Joint Replacement Program . Learn more about Dr. Travers.
My name is Chris Travers. I'm a joint replacement surgeon at the University of Pennsylvania and specifically, I'm the director of the Orthopedic Robotics Program. So I've always been interested in orthopedics from an early age. Specifically, joint replacement really appealed to me the mechanical nature of the joint and just the ability to really improve a patient's quality of life. What drew me to robotics is that it really is the next frontier of joint replacement, I'd say in the last 5 to 10 years, it's really taken off. We're still using the same implants, we're using the same techniques and the same ideas that have been around. It's just a, a very precise tool that allows us to be a little bit more accurate and really customize the placement of the implants to the patient's anatomy. So this is the point in the case when the uh when we start to diverge a little bit from traditional total knee replacement, we already have AC A T scan of the knee. So we have a 3D model, we know what the knee looks like, but this is our computer's eyes right here. It's a infrared uh system. These are the arrays, these are what the computer sees. So I'll attach these to the knee and now it has something that I can see, it can see these different points on the patient's knee. I'm gonna give the computer some data so it knows where everything is in space and then it can start feeding me information based on what we've gathered from the cat scan. The more traditional way of doing knee replacement is you take your measurements, you do your kind of best estimates and best alignment. And then after you've placed your implants, you start to do some little augmentations to the soft tissue around the knees. Robotics is different in the sense that you get a lot of that information before you've made a single cup. So you measure the tightness of the joint, you start placing the components differently in space in a very precise way. So by the time you put the implants in, everything is pretty much balanced at that point, let's lock it in the middle and give me two degrees good 17 and 20. Why don't you give me one more in the middle? And can you on the femur side lock immediately give me one of Varis. So we're getting close, we want 19 or 20 millimeters somewhere in that range and we're getting pretty close, we're much closer. And what we just did there was we adjusted the shape of the components or adjusted the angle in order to accomplish our goal, anything that causes the joint surface which is covered in cartilage to be damaged or uneven or malformed, we can replace that with an implant. And this, this device is really just an enabling tool. So anyone who can have a joint replacement can have a robotic joint replacement. It's still the surgeon using his own hands, using a very advanced uh basically power tool on a robotic arm. Now, you'll see when I bring the, the saw blade. So this is how we're gonna accomplish all of our, all of our surgery. We're gonna change the shape of the bone to accept an implant. I get it close and then the robot kinda gets me on angle. So now I'm exactly at the right angle that I planned before and I can't really move off angle. I can go straight, but I can't angle the ro the robot, I can't move it up or down. It resists me and keeps me honest and keeps me in the right place with robotic. It does give you a lot of feedback and it actually has some safety mechanisms built in. So there's a lot of important structures in the knee that we don't want to cut specifically in the back of the knee. The root will actually stop you from passing the saw too far back into those danger zones. It's also good for certain patients that have some unique conditions. So with a manual total knee replacement often times we have to place rods up and down the bones. Sometimes that's not possible. Someone has prior hardware like a plate or screws that prevents us from accessing the femoral canal, the tibial canal, we can actually bypass that whole step with robotics by taking some measurements and adjusting some of the settings of the robot. I'm able to change everything so precisely and place that implant wherever I want on the bone. Ultimately making a much more well balanced knee, uh something that's a little bit more precise to the individual patient. I think with total knee replacement, total hip replacement robotics is a kind of a natural progression. So you're still doing the exact same procedure. It doesn't have a huge effect on the recovery time afterwards. The patients still have to do physical therapy just as if they had had a manual joint replacement, they still have to rehab and build strength. So the protocols are fairly similar afterwards. It's just the technical details of the procedure and the precision is higher. Ultimately, our goal is to make these last longer and function better. The hope is that as we do more of these procedures and we kind of bank data, we see which patients do the best, which patients maybe have some more difficulty. And we're able to pick the parameters that are most important to achieve during total joint replacement.
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