Use of an ar­ti­fi­cial joint: “Cori” ro­bot now as­sists with knee surgery

Around 23,000 ar­ti­fi­cial knee joints are im­plan­ted in Aus­tria every year. Pa­ti­ent sa­tis­fac­tion af­ter the ope­ra­tion is pri­ma­rily ba­sed on op­ti­mal plan­ning and exe­cu­tion of the pro­ce­dure. Now, a ro­bot-as­sis­ted sys­tem en­ables even more in­di­vi­dual and pre­cise treatment. 

An in­no­va­tive, ro­bot-as­sis­ted sys­tem has been used for the first time in Aus­tria at the Evan­ge­li­cal Hos­pi­tal-Vi­enna since the be­gin­ning of Fe­bru­ary. The CORI sys­tem, de­scri­bed by sur­ge­ons as a “ro­bo­tic team mem­ber,” en­ables the me­a­su­re­ment, plan­ning and exe­cu­tion of a pro­ce­dure fully tail­o­red to the pa­ti­en­t’s in­di­vi­dual ana­tomy and life­style, as ex­plai­ned by Head of Or­tho­pe­dics, Prim. Univ.-Doz. Dr. Tho­mas Müllner.

How does the “ro­bo­tic team mem­ber” work?
Ba­sed on a CT scan, a de­tailed plan for the ope­ra­tion is crea­ted, tail­o­red to the pa­ti­en­t’s ana­tomy. This data is ta­ken over by “Cori”, whose cen­ter­piece is a high-speed mil­ling ma­chine, and im­ple­ments the spe­ci­fi­ca­ti­ons with the hig­hest pre­cis­ion.
For ex­am­ple, the ro­bot sys­tem au­to­ma­ti­cally stops the sur­ge­on’s hand as soon as en­ough bone ma­te­rial has been re­mo­ved. This pre­vents un­neces­sary bone wear and, for the first time, en­ables pre­cise mo­de­ling of the re­cess for the ar­ti­fi­cial joint to the nea­rest tenth of a millimeter. 

The ad­van­ta­ges for pa­ti­ents are di­verse. “This pre­cis­ion also al­lows the bone to fuse bet­ter with the im­plant. The re­sult is a highly sta­ble ar­ti­fi­cial joint, an op­ti­mi­zed fit and thus a lon­ger life­span, less pain and also a more na­tu­ral wal­king fee­ling in the knee,” ex­plains or­tho­pe­dic sur­geon, Doz. Dr. Ma­xi­mi­lian Kas­pa­rek.
Com­pu­ter-as­sis­ted knee na­vi­ga­tion has been used at the Evan­ge­li­cal Hos­pi­tal for over 20 ye­ars. Prim. Müll­ner: “The­r­e­fore, pa­ti­ent sa­tis­fac­tion has been over 93 per­cent for ye­ars. We would like to im­prove this re­sult for the be­ne­fit of the re­mai­ning pa­ti­ents with the new ro­bot sys­tem.“
Thanks to “Cori”, the vir­tual re­pre­sen­ta­tion is now even more ac­cu­rate, the 3D mo­del of the knee or the pro­sthe­sis can be ro­ta­ted in the room and viewed pre­cis­ely from all si­des. “If ne­ces­sary, fine ad­jus­t­ments are still made,” says the surgeon. 

In­itial ex­pe­ri­en­ces are very pro­mi­sing
Com­pa­ri­sons with con­ven­tio­nal knee joint ope­ra­ti­ons show that ro­bot-as­sis­ted use re­sults in a si­gni­fi­cant im­pro­ve­ment in terms of the exact fit of the pro­sthe­sis and a na­tu­ral wal­king fee­ling in the sen­si­tive tran­si­tion area bet­ween the kne­e­cap and the thigh bone.

“The first pa­ti­ent ex­pe­ri­en­ces make us very con­fi­dent that the po­si­tive study re­sults will also be re­flec­ted in our work,” re­ports Prim. Müll­ner. And he cla­ri­fies: “The safe landing still de­pends on the pi­lots: the more ex­pe­ri­en­ced they are, the more suc­cessful the ‘team­work’ with Cori, the new ro­bot mil­ling ma­chine, will be.”