Cori Robotic Knee Replacement

CORI robotic knee replacement is a cutting-edge surgical technique developed by Smith & Nephew that utilizes a handheld robotic system to perform both total and partial knee replacement surgeries.

CORI’s advanced surgical system enables surgeons to measure, plan, and carry out a knee replacement that is customized to the patient’s unique knee anatomy and increases the orthopedic team’s expertise to enhance the precision and results of a knee replacement.

Working Mechanism of the CORI Surgical System

Smith & Nephew’s CORI surgical system is a compact and completely mobile system that includes a 3D intra-operative imaging system with a state-of-the-art robotic sculpting tool. The surgeon can utilize a pointer device to highlight the bone surface that needs to be removed. Then, the surgeon uses a handheld cutting instrument that has a robotic attribute that automatically stops the spinning of the instrument’s burr when it is outside the marked area. It requires minimum setup time and can be moved across different operation theaters to optimize the flow of patients through surgical units. Smith & Nephew’s CORI system allows the patient to have a knee arthroplasty that can be aligned and shape-matched to the patient’s distinct knee anatomy. This robotic system does not necessitate CT and preoperative imaging and has the capability to improve both implant placement precision and operational efficiency.

Indications

Smith & Nephew’s CORI robotic knee system is indicated for partial and total knee replacement in patients suffering from degenerative knee disease, such as osteoarthritis, that is not responsive to conservative treatment.

Osteoarthritis is a degenerative joint disease that causes breakdown and eventual loss of cartilage in the knee joint making the bones rub against each other leading to painful movement.

Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn-out or damaged surfaces of the knee joint are removed and replaced with an artificial knee implant or prosthesis. Partial knee replacement is a surgical procedure in which only the damaged portion of the knee joint is removed and replaced with a prosthesis.

Preparation

Preoperative preparation for a CORI robotic knee replacement surgery may involve the following:

• A thorough history and physical examination
• Routine blood work and imaging
• Informing your doctor of any allergies to medications, anesthesia, or latex
• Informing your doctor of any medications or supplements you are taking or any conditions you have such as heart or lung disease, which may impact the surgery
• Refraining from medications such as blood thinners, aspirin, or NSAIDs, if indicated
• Refraining from solids or liquids at least 8 hours prior to surgery
• Arranging for someone to drive you home after surgery

Surgical Procedure

In general, Smith & Nephew’s CORI robotic knee replacement procedure is similar to a traditional knee replacement but is performed with the help of a hand-held robotic system. The robotic system does not perform the procedure on its own. The surgery is performed entirely by your surgeon by prompting the robotic hands based on the personalized plan developed by your surgeon. The CORI surgical system is only an additional tool to guide your surgeon to ensure greater accuracy in the placement of knee implants.

The CORI knee replacement surgery is usually done under general anesthesia with you appropriately placed on the operating table. An incision is made over the affected knee to expose the knee joint. The CORI surgical system uses a passive infrared tracking camera that is 4 times faster than that of its predecessor, the NAVIO Surgical System. It delivers more efficient cutting technology, with a two-fold increase in cutting volumes compared with its predecessor. This cutting-edge technology helps to determine the damaged areas of the joint that need to be removed for the precise placement of the knee implant. The robotic system makes adjustments - even with the slightest movement of your legs - ensuring the surgical plan designed by your surgeon is carried out without any changes and with a high degree of precision. The diseased portion of your knee is removed, and a customized implant is then secured over the prepared portion of your knee joint. Throughout the procedure, your surgeon is provided with real-time data by the CORI surgical system, which enhances your surgeon’s skill, enabling accurate placement of the knee implant. With the new implant in place, the knee is taken through a series of range-of-motion movements. The muscles are then approximated, and the incision is closed and covered with a sterile dressing.

Postoperative Care

Following surgery, you will require pain management with medications and ice packs. Incision site care and bathing instructions will be provided to keep the wound clean and dry. You should refrain from strenuous and heavy lifting activities for a defined period. A knee brace or immobilizer may be recommended to protect the repair, depending on your surgeon’s preference.

The healing process may take anywhere from 8 to 12 weeks. You will require the use of crutches until you are able to walk without assistance. A physical therapist will teach you specific exercises to strengthen your leg muscles and restore knee movement. You should be able to resume your normal activities in a couple of months. Follow-up appointments will be scheduled to monitor your progress.

Risks and Complications

CORI robotic knee replacement is a relatively safe procedure; however, as with any surgery, there are risks and complications that can occur, such as:

• Pain
• Bleeding
• Infection
• Knee stiffness/instability
• Blood clots or deep vein thrombosis (DVT)
• Allergic/anesthetic reactions
• Injury to nerves or blood vessels

Benefits

The benefits of CORI robotic knee replacement include:

• Smaller incisions
• Minimal postoperative pain
• Minimal muscle trauma/scarring
• Greater accuracy in implant placement
• Improved implant longevity
• Shorter hospital stay
• Rapid recovery
• Lower risk of revision replacement
• Higher patient satisfaction

Summary

The CORI robotic knee replacement is a novel surgical alternative for patients with degenerative joint disease (DJD). The CORI surgical system is the most efficient and advanced handheld robotic solution designed to change the field of orthopedic surgery, and is one of the most cost-effective, portable, and compact robotic systems in the market today.