Value of navigation and robot-guided surgery in total knee arthroplasty

Up to now robotics play a minor role in orthopedic surgery because the financing and daily costs of these devices overburden the budgets of normal hospitals. The technical demands are time consuming and pose an additional cost factor. The trauma to the patients in the opinion of some authors is considerable. Nevertheless, robotics play an important role in the further development of orthopedic surgery because improvements in technology will lead to a better operative outcome for the patients. Navigation devices have been developed in the last few years in different centers. From the medical point of view, it is important that navigation systems support surgeons in the analysis of all questions concerning alignment. This pertains not only to rotation analyses of the femur and tibia components but also to analyses of the cinematic gap in flexion and extension. The handling of soft tissues has an important influence on the postoperative function of the knee. It is also a medical issue that the navigation systems should be open, i.e., that different designs of implants could be implanted with one navigation device. There are some systems which offer this quality. Improvements in technology are necessary especially in rotation analyses of the lower limb.