Robot takes the pain and guesswork out of knee and hip replacements



British doctors have helped to create a surgical robot that will revolutionise treatment for the 160,000 people a year who are given a new knee or hip.



The Sculptor robot enables surgeons to install replacement joints in exactly the right place and removes the risk of them not fitting properly. Ill-fitting joints can cause patients pain and force them to undergo corrective operations. Sensors in the positioning arm of the Sculptor tell the computer where the surgeon is cutting away bone.

The machine stops surgeons from making a mistake while they are removing the old, worn bone in an arthritic knee by disabling their mechanised cutting tool if they stray outside the area shown in a model of the knee in its computer. It is the first orthopaedic surgical tool to use this 'actively constraining' technology, which has been developed after 15 years of research by a team of engineers, computer scientists and doctors at Imperial College London. The team was led by Professor Justin Cobb and Professor Brian Davies.

The robot has been used at Charing Cross Hospital in London in three knee-replacement operations. Its precision helps to ensure a cleaner, smoother match between the healthy bone that is left and the two new pieces, one metal and the other plastic, that are inserted into the knee. Currently, as many as 30 per cent of people who have knee surgery feel some restriction that may be related to the accuracy with which the operation was performed. In some it fails altogether.

Experts predict that the number of people needing knee replacements will soar by 700 per cent by 2030, with those requiring a prosthetic hip rising by 200 per cent. Growing numbers of the postwar 'baby boomer' generation are living longer and leading more active lives, so more of them are finding that their joints are wearing out.

'The Sculptor is a partnership between man and machine. It uses the computer's strength, which is in measurement and analysis, and the surgeon's strength, which is application of engineering to humans,' said Alister Hart, a consultant orthopaedic surgeon at Imperial College Healthcare NHS Trust, who has used the robot. It is being built and sold by Acrobot, a British technology firm specialising in robotic surgical equipment.

'I can see why people might be worried about a robot operating on their knee, because machines can go wrong, but with the Sculptor the surgeon is still in control,' added Hart.

Paula Geschwind, a 68-year-old retired nurse who suffered from osteoarthritis, recently underwent surgery to partially replace her left knee. The Sculptor was used during the operation.

'After four weeks, the movement in my knee is better than before and I'm looking forward to being able to walk freely, without the constant pain I've had in recent years that forced me to take heavy painkillers,' she said. 'The robot will help surgeons with really superb alignment, which should mean that all those people that have trouble with their new knee once it has been fitted no longer do because it's in the right place.'

Tuesday, December 2nd 2008
Guardian
           


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