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Choose Dr. Morton as your Joint Replacement Surgeon

This is a complete guide to robotic joint replacement.

In this guide you’ll learn all about:

  • History of Robotics in Orthopedics
  • Benefits and Advantages of Robotics
  • Different Orthopedic Robots
  • Evidence Behind Robotic Surgery
  • Training Required
  • How to Prepare for you surgery

So if you want to make sure that you get the most out of your hip or knee surgery, you will get a ton of value from today’s guide.

Robotic Hip and Knee Surgery


Role of Robotic-Assistance in Hip and Knee Joint Replacement Surgery
Robotic Surgery History
Anterior total hip replacements
Performing a Robotic Surgery
Robot-Assisted Total Knee Procedure Video Demonstration
Different Robotic Orthopedic Procedures
Robotic Systems
Specialized Training
Frequently Asked Questions
Schedule Appointment

Role of Robotic-Assistance in Hip and Knee Joint Replacement Surgery

Benefits of Robotic Surgery
  • More data collected intraoperatively
  • Increased accuracy
  • Real-time info on size, alignment, and balance
  • Improved real-time surgical decisions
  • Optimized ligament balance
  • Personalized implant position
  • Consistent leg alignment
  • Improved safety with bone cuts

Robot-assisted surgery is a new, exciting tool in orthopedics. In industry, robotic arms have made an incredible difference in efficiency, accuracy, and consistency in manufacturing.

Robots have made advancements in urology, spinal surgery, general surgery, gynecology, gastrointestinal surgery, and many other fields. It makes sense that robots would make their way into joint replacement surgery.

Robotic-assisted surgery is now involved in hip and knee replacements.

While conventional surgery methods for joint replacements have a tremendous success history, this new technology offers many exciting advantages in 2020.

Orthopedic surgeons have a variety of systems to choose from based on their preferences. I will go into the details of these different systems below.

The problem with conventional joint replacements

Hip and Knee replacement surgeries are incredibly successful operations. In fact, the Lancet named total hip replacements “the operation of the century.”

However, hip replacements are known to have problems with dislocations and limb length discrepancies. In patients with hip dysplasia or other deformities in their hips often have distorted anatomy. While anterior hip replacements have improved some of these problems, there is still room for improvement.

Knee replacements are considered an incredibly successful surgery. However, 20% of patients are still dissatisfied with their surgery. In studies of total knees performed on patients in Hawaii by excellent orthopedic surgeons using mechanical jigs, only 86% of these implants are placed in the appropriate position.

Keep reading to learn how robotics improves our surgical techniques.

Robotic Surgery History

Knowing the past helps to understand the future.
It’s important to see where we have come from to improve our surgical outcomes.

What are my goals after Surgery?

Traditionally, orthopedic surgeons replace joints manually using special tools. These tools are rigid in their placement of knees and do not allow for easy personalization of placement of the implant.

In addition, the instruments for these joint replacements have to be re-sterilized before each surgery. Robotic surgery eliminates the need for these steps, thus limiting the room for error and possible bacterial contamination. Bacterial contamination is a serious complication.

Mechanical Tools

The surgeon has to choose and position the implant using his or her own judgment and visualization. Many surgeons successfully improve their patients’ pain and overall function using this manual method, but there are still some concerns that there is room for error.

instruments Mechanical Tools
Computer Navigation

For a short period of time, many orthopedic companies were showing computer-navigation knee replacements. Computer-guided knee and hip replacements use markers that are pinned to the patient to determine the alignment of the implant. Navigation proved more accurate with implant positioning compared to mechanical jigs. Unfortunately, this technology is harder to use and has not been able to demonstrate improved outcomes for patients.

Evolution of Robotics in Surgery

More recently, robotic-assisted surgery has become more popular as technology improves. Robotic surgery is a drastic improvement compared to joint replacements performed with computer navigation or mechanical jigs. Surgical robots are more precise, which offers multiple benefits throughout the surgery.

There are three main types of robots: active, haptic, and passive. Active systems attempt to perform the entire operation with minimal input from the surgeon. Studies have not demonstrated that these systems are much better than navigation. Passive and semi-active systems, where the surgeon does the majority of the work and the robot functions as a supportive role, are popular. The robot provides feedback on re-shaping the bone and positioning of the implant. This leads to more precision than the human eye.

Evolution of Robotics in Surgery

Dr. Morton is fellowship-trained in robotic-assisted joint replacements and one of the few surgeons in Hawaii to perform this procedure.

Schedule Your Consultation

Preoperative Planning

Prior to surgery, some robotic systems require the use of advanced imaging such as a long-leg standing film or a CT scan. This imaging allows for:

  • Accurate sizing of implants prior to surgery
    • Less guess-work on sizes before
    • Shorter operating period
  • Preoperative measurement of patient’s deformity prior to surgery
Preoperative Planning Rosa Knee Replacement

Rosa Knee Replacement uses x-rays with special calibration markers that allow for accurate determination of preoperative alignment and sizing.   After these x-rays are obtained, a preoperative plan is personalized to each patient before surgery is even performed.

Preop Plan for Rosa Total Knee Arthroplasty

Performing a Robotic Surgery

There are some big differences when utilizing the robot to perform your surgery. Below is the step-by-step process of how a robotic knee is performed.
Stay tuned for a video demonstration.

Insertion of Pins and Calibration of the Robot

Navigation pins allow for the proper utilization of the robot.

Insertion of Pins and Calibration of the Robot
Exposure of the Joint

This is performed much in the same way that is done during a normal knee or hip replacement. Soft-tissue releases that are normally performed – do not have to be done.

Collection of Bone Landmarks

Dr. Morton will trace out the bone landmarks on your knee replacement, obtaining real-time information to map out your knee anatomy.

Collection of Landmarks
Soft-tissue balancing information

The soft-tissue gap balancing information obtained during a robotic joint provides information not normally evaluated during a knee replacement.  This evaluation alerts the surgeon to your specific soft tissue anatomy and helps guide customized, patient-specific implantation of your hip or knee.

Soft Tissue Information Collection
Implant positioning

Your surgery is then planned on a computer screen prior to the actual implantation.

soft tissue balancing
Robotic-assisted Bone Preparation

The robot then guides the cuts through the cutting guides. The robot provides an increased accuracy that cannot be matched by the human eye. These cuts are confirmed to be accurate after they are made.

Cut 1
cut 2
Placing the Implant

Once the bone cuts are made, Dr. Morton will place your new hip or knee in the correct position.

Final Implantation

Robot-Assisted Total Knee Procedure Video Demonstration