Robotics-Assisted Knee Surgery | Sagewell - Orthopaedics, Urgent Care

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At Sagewell Orthopaedics, Dr. Scott Strasburger and our expert team are committed to providing the most advanced care available. Robotics-assisted knee surgery with Smith+Nephew implants may help deliver the ultimate knee replacement experience, potentially allowing for a quicker, smoother recovery*¹,²† using a naturally shaped knee made from materials designed to last.

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Orthopaedics

Knee Replacement Has Changed — For the Better

The first knee replacement procedures were performed in 1968, relying on manual guides to remove damaged bone and place the implant. Over time, techniques evolved to use long metal alignment rods inserted into the thigh bone (femur) to help determine the correct alignment. While these methods were an improvement, they had potential drawbacks. The use of alignment rods could lead to a risk of complications like fat embolisms³, and newer pre-surgery imaging like CT scans could result in radiation exposure, while MRIs might increase costs and time-to-procedure.

The Potential of Robotics-Assisted Knee Replacement

Enter robotics-assisted surgery: this modern approach combines the advantages of traditional methods with new innovations while minimizing the drawbacks. This advanced technology, utilized by Dr. Strasburger, is intended to help your surgeon plan and perform your knee replacement with a greater degree of accuracy than traditional methods may offer,⁴⁻⁸ and without the need for metal rods, CT scans, or pre-surgical MRIs. Smith+Nephew, the only company offering handheld robotics-assisted technology for both partial and total knee replacements, believes this enhanced accuracy may help lead to improved long-term outcomes.⁴⁻⁶,⁹

The CORI◊ Surgical System: A Higher Standard of Care

When a highly skilled surgeon is equipped with the latest in robotics-assisted technology, you may have greater peace of mind knowing you are being offered an advanced standard of care. At Sagewell Orthopaedics, we use the CORI◊ Surgical System.

A Unique Plan for Your Unique Anatomy
Your knee replacement surgery is as unique as you are. Using the CORI◊ Surgical System, your surgeon creates a customized 3D digital model of your knee. This detailed view helps finalize and verify the right size implant for you and creates a surgical plan to optimize movement and function. This digital model also eliminates the need for a pre-operative CT scan, reducing your exposure to radiation.

A Natural Fit with Surgical Precision
The CORI◊ Surgical System is intended to empower your surgeon to perform the procedure as planned. It combines the accuracy of robotics with the skill and training of your experienced surgeon.⁵,⁶,¹⁰,¹¹ The system sends precise information about your knee to the robotics-assisted handpiece more than 300 times per second, allowing your surgeon to remove damaged surfaces, balance your joint, and position the implant with high accuracy.⁷,¹⁰,¹¹,¹⁸,²⁰,²¹

A Wide Selection of Advanced Implants
Knee replacement shouldn’t be one-size-fits-all. The CORI◊ system allows your surgeon to select from a wide range of implants.¹⁴ Only Smith+Nephew knee implants may be made with a highly durable material called OXINIUM◊ Oxidized Zirconium, which has been lab-tested to last significantly longer than conventional implant materials.¹⁵,¹⁶ This means your new knee may be positioned with improved accuracy and made from materials designed for long-term performance.

Why Does My Knee Hurt?

One of the most common reasons for knee pain is osteoarthritis, often called "wear and tear" arthritis. As this disease progresses, the smooth cartilage that cushions your bones breaks down, causing joints to become swollen, painful, and hard to move.¹⁷ While there is no cure for osteoarthritis, many treatment options exist. Dr. Strasburger can help you explore solutions, which may include:

Lifestyle changes like weight loss and low-impact exercise
Physical therapy
Medications to reduce swelling and relieve pain
Surgical options, such as partial or total knee replacement

Which Type of Replacement is Right for Me?

The CORI◊ Surgical System works with both partial and total knee replacements, giving you more options.

Partial Knee Replacement
This procedure may be an option for patients with early to mid-stage knee damage. Your surgeon replaces only the damaged area of your knee, preserving healthy tissue and ligaments. Accurate implant placement is important, and the Smith+Nephew robotics-assisted system is designed to help create a surgical plan that allows you to keep as much of your healthy bone and cartilage as possible.

Total Knee Replacement
For more advanced knee damage, a total knee replacement may be recommended. This procedure replaces the entire knee joint. Because no two knees are the same, the CORI◊ System’s robotics-assisted handpiece adds a layer of planning and accuracy, allowing your surgeon to match the implant’s position as closely as possible to your knee’s natural range of motion.

The result is a naturally shaped knee, positioned with an added level of accuracy that may help you experience a quicker, smoother recovery.*¹,²†

Ready to Take the Next Step?

Discover how robotics-assisted knee surgery at Sagewell Orthopaedics may help you return to the life you love.

Schedule a Consultation with Dr. Strasburger

Important Safety Notes

Knee replacement surgery is intended to relieve knee pain and improve knee functions. Not all patients are candidates for Smith+Nephew knee products. Implants may not produce the same feel or function as your original knee, and individual results will vary. Potential risks include loosening, wear, and infection that may result in the need for additional surgery. There are risks associated with any surgical procedure, including CORI-enabled Knee Replacement. The CORI◊ Surgical System is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, and morbidly obese patients should not undergo a CORI-enabled procedure. The information listed here is for informational purposes and is not meant as medical advice. For more information, please talk to your surgeon to determine if the CORI◊ Surgical System is right for you.

References

Partial knee replacement vs conventional techniques
¹Sephton BM, Bakhshayesh P, Edwards TC, Ali A, Kumar Singh V, Nathwani D. Predictors of extended length of stay after unicompartmental knee arthroplasty. J Clin Orthop Trauma. 2019. 11(Suppl 2):S239-45
²Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771
† n=28 (n=11 robotic procedures)
³Al-Shaer DS, Ayoub O, Ahamed NA, Al-Hibshi AM, Baeesa SS. Cerebral fat embolism syndrome following total knee replacement causing a devastating neurocognitive sequelae 2016 Jul; 21(3): 271-274
⁴Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship. J Robot Surg.
⁵Batailler C, White N, Ranaldi FP, et al. Improved implant position and lower revision rate with robotic assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27:1232.
⁶Herry Y BC, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
⁷Gregori A, Smith JR, Picard F, Lonner JH, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery (CAOS) 15th Annual Meeting; 2015; Vancouver, Canada.
⁸Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. Preliminary experience with an image‑free handheld robot for total knee arthroplasty: 77 cases compared with a matched control group. Eur. J. Orthop Surg Traumatol. 2020;30(4):723-9
⁹Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Why Are Total knee Arthroplasties Failing Today? Clinical Orthopaedics and Related Research. 2002;404:7-13
¹⁰Bollars P, Boeckxstaens A, Mievis J, Janssen D. The Learning Curve and Alignment Assessment of an Image-Free Handheld Robot in TKA: The First Patient Series in Europe. Poster presented at: 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery. 2019; New York, USA.
¹¹Kopjar B, Schwarzkopf R, Chow J, et al. NAVIO Robotic Assisted Surgical System for Total Knee Arthroplasty Using JOURNEY II Guided-Motion Total Knee System. Poster presented at: ISTA 2-5 October, 2019; Toronto, Canada.
¹²00225 V3 JOURNEY II Design Rationale 11.17.
¹³Shearman AD, et al. Robotic-assisted unicondylar knee arthroplasty is associated with earlier discharge from physiotherapy and reduced length of stay compared to conventional navigated techniques. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain
‡ n=62 (31 robotics)
¹⁴Smith+Nephew 2020. Comparison of the number of available implants for robotic-assisted knee arthroplasty systems. Internal Report. EO.REC.PCS015.001.v1
¹⁵Heyse TJ, Chen DX, Kelly N, et al. Matched-pair total knee arthroplasty retrieval analysis: Oxidized zirconium vs. CoCrMo. The Knee. 2011;18:448-452.
¹⁶Papannagari R, Hines G, Sprague J and Morrison M. Long-term wear performance of an advanced bearing knee technology. ISTA, Dubai, UAE, Oct 6-9, 2010
¹⁷https://www.arthritis.org/diseases/osteoarthritis. Accessed 22 Oct 2020
¹⁸Gregori A, Picard F, Bellemans J, Smith JR, Simone A. Handheld Precision Sculpting Tool for Unicondylar Knee Arthroplasty. A Clinical Review. Poster presented at: 15th EFORT Congress;4-6 June, 2014; London, UK
¹⁹Geller JA, Rossington A, Mitra R, Jaramaz B, Khare R, Netravali NA. Rate of learning curve and alignment accuracy of an image-free handheld robot for total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.
²⁰Mitra R, Jaramaz B, Nikou C, Kung C. Accuracy Assessment of a Novel Image-Free Handheld Robot for Knee Arthroplasty in Bi-Cruciate retaining knee and total knee replacement - A Cadaveric Study. World Arthroplasty Congress;2018; Rome, Italy.
²¹Kaper BP, Villa A. Accuracy and Precision of a Handheld Robotic-guided Distal Femoral Osteotomy in Robotic-assisted Total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain