Robotic arms perform invasive orthopaedic surgery, though pin spikes still are leaving postoperative drawbacks consistently, causing periprosthetic fractures.

In widely practiced robot-assisted surgeries, the bone array pins, affixed to the femur and tibia long-bones through smaller incisions many times are recorded to yield postoperative difficulties. The additional incisions for pin placements, the pinholes, the experts said, “Sometimes causes higher risk of fractures and even infections.”

“In TKA (total knee arthroplasty), the pins are placed through separate incisions away from the main incision, but the rate of fractures have reduced drastically,” said Dr Sunil G Kini, orthopaedic surgeon and robotic joint replacement surgery, Manipal Hospital, Bengaluru. Dr Kini, after presenting an effective orthopaedic management session here, said, “The infection rates in postoperative robotic surgery are however the same as conventional joint replacement surgery.”

The increasing incidents of postoperative periprosthetic fractures due to internal placement of pins have been causing a significant clinical and economic burden in case of total hip replacement (THR). A study claimed that the rate of such fractures that currently reads 3.5 per cent in THR is likely to scale up by 4.6 per cent globally, over the next 30 years. But, in case TKA, a rare complication out of the insertion of pins across the femoral and tibial shafts has been recorded and the experts claimed that the rate of such fractures has come down to 1.38 per cent.

“Only 1 in 1,172 patients developed a pin-related periprosthetic fracture after robot-assisted TKA,” said a senior robotic surgeon, adding, “By 2030, each one in two TKA procedures will use robotic arm assistance with further more precision, much lesser fractures as we can estimate.”

Dr Arunangshu Ganguly, senior cardiologist and managing director of Health World Hospital in Durgapur, said, “With the recent developments, pinhole fractures surely have come down remarkably.” The hospital recently has introduced robotic surgery. World’s first robotic surgery was directed by Dr Robert E Michler in 1994 at Ohio State University Medical Centre, USA. The first surgical robot PUMA 560 was used in 1985 for a brain biopsy. The All India Institute of Medical Science recorded robotic installation for the first time in the country in February, 2000, after US’s approval of the Da Vinci System of robotics.”

Caption: Representational image of most modern Da Vinci surgical robot below