Landmark trial for treating knee pain

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Robotic technology has created major advances in surgical treatments – but does it always provide the best outcomes for patients?

A landmark new trial is seeking to answer that question, specifically for people who require knee replacement procedures.

“The information that we’re able to attain from this study is going to help patients in the future by determining whether robotics becomes the standardised approach for everyone having a knee replacement,” said Dr Samuel MacDessi, Chairman of Orthopaedics at St George Private Hospital in Sydney.

Funded by Ramsay Health Care Australia’s Hospital Research Foundation, it will investigate the cause of common, persistent pain in patients following a Total Knee Arthroplasty (TKA). 

The traditional gold-standard method involves computer-assisted surgery with mechanical alignment, whereby the surgeon is guided on-screen using infra-red technology to put the implant in a similar position for most patients.

Up to 20 percent of patients report some dissatisfaction following this type of operation.

The trial will seek to compare pre- and post-operative outcomes with Robotic Assisted Surgery in Kinematic Alignment (RASKAL), a technique where the computer helps to control the surgical instruments and the implant is positioned according to the specific anatomy of the patient's knee.

Dr Samuel MacDessi

“We know that the most beneficial treatment for when patients have end-stage arthritis is that of total knee replacement surgery,” Dr MacDessi said. 

“While it’s successful for the majority of people who undergo the surgery, there’s still a fifth of people who report some level of dissatisfaction from the operation.”

A third of Australians over the age of 65 will have knee osteoarthritis significant enough to affect their quality of life, and TKA has become a common operation to reduce pain and improve joint function.

“This is going to be a landmark trial that will tell us whether the use of robotics in knee replacement surgery will improve the outcomes for patients so that it can potentially be used on a more routine basis in the future,” Dr MacDessi said. 

“This trial is important for not just solving one major issue, that is ‘Do robots make a difference?’, but also, is this new method of aligning knees better than the current technique that’s been used for 45 years?”

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