Surgical Robotic System Advances Total Joint Replacement

Innovative active robot technology helps surgeons perform total knee replacement (TKR) procedures with accuracy and precision.

The THINK Surgical (Fremont, CA, USA) TSolution One Total Knee Application is a three-dimensional (3D) graphical preoperative planner and implementation tool for the treatment of patients who require primary total knee arthroplasty (TKA). The system consists of TPLAN, a 3D planning workstation that helps a surgeon design the position and orientation of the implant components. TPLAN first converts a CT scan into a 3D surface model of the joint. The surgeon then selects an implant from a library and places it along the axes of the bone, using anatomical landmarks, in order to achieve optimal fit and alignment.

The second component is TCAT, which consists of an electromechanical arm, an arm base that includes control electronics and a computer, a display monitor, operating software, pendant control, and tools and accessories, for the implementation of the preoperative plan at submillimeter precision. To do so, the surgeon uses a digitizer to locate the exact position required in the patient’s anatomy for precise surgical implementation, using a range of specialized drill bits. If bone motion occurs, the system is halted, and the registration system recovers bone position and resumes surgery.

"One of the advantages of the TSolution One System is the open implant library offered by this active robot system, which provides an optimal personalized surgical plan for each patient with precise bone-cutting technology,” said Mark Sparta, president of Hackensack University Medical Center (NJ, USA). “The addition of this fully active robot enhances Hackensack University Medical Center's robust surgical robotics program and demonstrates our commitment to providing our patients the best care with the most advanced technology available.”

Proper axial alignment is of paramount importance for the longevity of the TKR implant, and even minor deviations can lead to early loosening, increased polyethylene wear, and poor function. Misalignment of any of the components in any anatomical plane can cause major complications. For example, inaccurate rotation of either the femoral or tibial component will critically affect patellar tracking and can lead to patellar subluxation or dislocation.

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