Quantitative Analysis of Technological Innovation in Knee Arthroplasty

Dalton, David; Burke, Thomas; Kelly, Enda; Curtin, P.

doi:10.1016/j.arth.2015.12.031

Cited by 22 publications

(29 citation statements)

References 12 publications

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“…The concept of MIS was obviously very appealing to patients for cosmesis reason and ultimately to surgeons. In 2016, Dalton et al [97] showed how companies are actually now driving innovation in orthopaedics and MIS was probably one of their greatest successes.…”

Section: Discussionmentioning

confidence: 99%

“…This new approach to TKR was driven by several factors. First of all other specialties were ahead of orthopaedic surgery with regard to minimally invasive surgery principles [8]; second of all, the resurgence of UKR using mini-invasive approach gave surgeons the skills to transpose similar technique to TKR [98, 99]; third the development of computer-assisted technology with the navigation and robotic surgery which interestingly followed the progression of UKR growth on the market [12, 97]; and finally the rapid adoption of enhanced recovery thinking in arthroplasty surgery [61, 62]. …”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

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In this review, we outlined the definition of minimally invasive surgery (MIS) in total knee replacement (TKR) and described the different surgical approaches reported in the literature. Afterwards, we went through the most recent studies assessing MIS TKR. Next, we searched for potential limitations of MIS knee replacement and tried to answer the following questions: Are there selective criteria and specific patient selection for MIS knee surgery? If there are, then what are they? After all, a discussion and conclusion completed this article. There is certainly room for MIS or at least less invasive surgery for appropriate selected patients. Nonetheless, there are differences between approaches. Mini-medial parapatellar is easy to master, quick to perform and potentially extendable, whereas mini-subvastus and mini-midvastus are trickier and require more caution related to risk of haematoma and vastus medialis oblique (VMO) nerve damage. Current evidence on the safety and efficacy of mini-incision surgery for TKR does not appear fully adequate for the procedure to be used without special arrangements for consent and for audit or continuing research. There is an argument that a sudden jump from standard TKR to MIS TKR, especially without computer assistance such as navigation, patient-specific instrumentation or robotic, may breach a surgeon’s duty of care towards patients because it exposes patients to unnecessary risks. As a final point, more evidence is required on the long-term safety and efficacy of this procedure which will give objective shed light on real benefits of MIS TKR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive total knee replacement: techniques and results

Picard

Deakin

Balasubramanian

et al. 2018

Eur J Orthop Surg Traumatol

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“…In June 2016, Dalton et al published a very relevant article we would like to refer to as the common theme of this section [57]. Between 1980 and 2014, the authors examined patents and papers in relation to knee surgery and sorted them into four clusters of innovations, which could be used to link patents and publications:…”

Section: Impact Of Caos On General "Orthopaedic Forum"mentioning

confidence: 99%

“…The number of patents dedicated to navigation after 2008 reduced, whereas more investment was directed towards on PSI and two years later towards robotic technologies [57] (Figure 2). Also by 2008, the number of publications for navigation declined whereas they increased for PSI [74,75].…”

Section: Impact Of Caos On General "Orthopaedic Forum"mentioning

confidence: 99%

Computer assisted orthopaedic surgery: Past, present and future

Picard

Deakin

Riches

et al. 2019

Medical Engineering & Physics

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Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery which is why it is baffling that it is not the case for orthopaedic surgery with less than 5% of surgeon using available computer 2 technology in their surgeries. In this review, we explore the evolution and background of computer assisted orthopaedic surgery (CAOS) delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found that industry had an important role in driving the discussion at least in knee arthroplasty a leading field of CAOS with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Despite this, the future of CAOS remains positive with new technologies such as improvements in imageguided surgery, enhanced navigation systems, robotics and artificial intelligence.

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“…In the United States, 15∼20% of UKAs are performed under the assistance of robotic devices, and the rate is projected to reach over 37% in the next decade [14]. Furthermore, publications and patents related to raUKA have also been on the rise dramatically [15]. However, recent studies showed that improved precision failed to benefit function recovery, lower revision rate or protract implant survivorship [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted unicompartmental knee arthroplasty: a review

Liu

et al. 2021

Arthroplasty

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Purpose Presented here is an up-to-date review concerning robotic-assisted unicompartmental knee arthroplasty (rUKA), including its rationale, operative system, pros and cons. Methods We did a systematic research in electronic databases, including PubMed, Cochrane Library, Web of Science, and Embase up to March 30, 2020 to retrieve literature pertaining to rUKA. The search strategies “(robotic* AND knee arthroplasty OR knee replacement)” and “(knee arthroplasty OR knee replacement NOT total)” were used. Studies describing rUKA and clinical trials, dry bone or cadaveric researches regarding technologies, positioning, alignment, function, or survivorship of implants were included in this review. All retrieved studies were first browsed for eligibility on the basis of title and abstract, and the selected studies were further evaluated by reading full text for final inclusion. Results Robotic-assisted technology has been found to increase the accuracy of bone preparation and implant placement, reduce technical variability and outliers, and enhance reproduction of limb alignment. Additionally, early clinical outcomes were excellent, but mid-term follow-up showed no superiority in component survivorship. The potential drawbacks of the robotic-assisted technology include relatively-low time- and cost-effectiveness, development of some rUKA-related complications, and lack of support by high-quality literature. Conclusion This review shows that rUKA can decrease the number of outliers concerning the optimal implant positioning and limb alignment. However, due to absence of extensive studies on clinical outcomes and long-term results, it remains unclear whether the improved component positioning translates to better clinical outcomes or long-term survivorship of the implant. Nevertheless, since an accurate implant position is presumably beneficial, robotic-assisted technology is worth recommendation in UKA.

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Quantitative Analysis of Technological Innovation in Knee Arthroplasty

Cited by 22 publications

References 12 publications

Minimally invasive total knee replacement: techniques and results

Minimally invasive total knee replacement: techniques and results

Computer assisted orthopaedic surgery: Past, present and future

Robotic-assisted unicompartmental knee arthroplasty: a review

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