The Role of Robotics in Knee Replacement Surgery (RoboKnees): A Pilot Randomized Controlled Trial

Knee replacement surgery is the second most common surgery in Canada. Patients who have very painful knee arthritis usually receive a total knee replacement even if their knee is only partially damaged by arthritis. This is because partial knee replacements are difficult for most surgeons to do manually, while total knee replacements are well taught and routinely performed at nearly every institution, making them the simpler solution for the problem, but perhaps not the correct one. Our hospital recently acquired the first orthopaedic surgical robot in Canada which we believe can help us give many people a partial knee replacement rather than a total knee replacement, thereby preserving parts of the patient's own knee that are not affected by disease. This may help people recover faster and have a more natural feeling knee after surgery. However, sometimes partial knee replacements do not last as long as total knee replacements. We think that the robot can help surgeons place the partial knee implant more accurately so that the implants last longer. We plan to conduct a pilot randomized trial to determine if the robotic technology can help surgeons place the implant properly to ensure it lasts a long time, as well as helping patients have a more natural feeling knee and faster recovery after knee surgery. For patients who have arthritis damage in only one section of their knee, we will randomize them to receive a total knee replacement, which is standard care, or a robot-assisted partial knee replacement. This is a pilot study so we will be assessing our ability to enroll enough patients and we will work out any logistical challenges that arise. We will collect preliminary clinical outcomes to help us conduct a larger trial in the future.