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Recent Trends in Total Knee Replacement

By Dr. Ramneek Mahajan in Orthopaedics & Joint Replacement

Aug 01 , 2022 | 2 min read

Knee Joint replacement is an effective treatment for the management of arthritis. It involves the removal of the damaged joint and replacing it with metal components, thus allowing pain-free movement. With an active, longer living population and a trend for joint replacement earlier in life, there have been many advancements. We shall explore some of these recent developments in this article.

Cementless Knee Total Knee Arthroplasty

Traditional total knee arthroplasty prostheses have been implanted with bone cement to affix the implant to the bone. The implant is created in a way so that cement is not required for the fixation of the implant. Its advantage is reducing the rate of wear and loosening.

Implant Surface Modification

The implant's surface is modified in such a way that it improves the strength of fixation and has some antibiotic properties. Titanium has been the top choice for the advances in surface modification. Surface modifications aim to improve fixation strength by encouraging ongrowth or ingrowth of bone.

Modulating a titanium surface nanostructure has been shown to reduce infection caused by bacteria responsible for over 50 percent of joint infections- thus, maximising the effectiveness of antibiotics administered in the perioperative period. The addition of silver nanoparticles has shown to be effective against some common infection-causing organisms.

3-D Printing and Custom Implants

Newer technologies like 3-D printing have allowed doctors to custom print the unique requirements of a patient's prostheses; this customisation of implants provides a personalised solution for knee joint construction. A majority of arthroplasty cases may not require such a customised approach. Revision surgery may also benefit from this approach.

Computer Navigation Surgery

Computer navigation is used to guide the positioning of instruments and implants. It allows surgeons to improve the accuracy of implant positioning and surgery outcomes.

Robotic-Assisted Surgery

One of the more exciting developments in joint arthroplasty is robotic assistance to aid critical decisions. Robotic-assisted joint replacement surgery is not a new procedure type; systems have been available since the 1980s. Robotic surgery is an evolution of navigated joint replacement surgery.

It takes it a step further, with the robot helping the positioning instruments or controlling the function of tools to ensure that the bone resection matches the planned operation. There is evidence that robotic surgery can help improve implant positioning accuracy compared to manual placement in hip and knee arthroplasty surgery.

Robotic surgeries are generally of two types – autonomous and semiautonomous. With the autonomous robotic-assisted system, surgeons start by performing their surgical plan and the initial incision. Then, the robotic system can complete the remaining surgery without the surgeon's input.

Semiautonomous robotic-assisted systems use the benefits of a navigation system and an autonomous robotic system. Semiautonomous robots are controlled and manipulated by the surgeon. The surgeon's control is modulated by the robot to limit bone preparation to the surgical plan.