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Orthopaedic Surgery

Navigation vs. robotics

Navigation systems deliver both clinical and economic advantages.

In total knee arthroplasty (TKA), computer-navigated procedures are becoming the dominant approach. These procedures are increasingly being found to be more advantageous than conventional operations. Not only patient satisfaction is generally higher, the precision of the implantations is greater. At the same time, the rate of complications is low as is the cumulative rate of revision. Robotic surgical systems are also becoming more and more important. In contrast to navigation systems, robotic systems execute actual steps of the operation – for example, skin incisions. Looking at all of the available evidence, robotic systems cannot yet provide the optimal combination of clinical and economic benefits that are currently available with navigation systems.

Two surgeons in the OR with a computer-navigated system in total knee arthroplasty

Benefits of navigation systems compared to robotic-assisted procedures at a glance

Info graph: Benefits of navigation systems compared to robotic-assisted procedures at a glance

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[1] Mezger U, Jendrewski C, Bartels M. Navigation in surgery. Langenbecks Arch Surg. 2013 Apr; 398(4): 501-14.

[2] Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D. Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am. 2007 Feb;89(2):261-9.

[3] Novak EJ, Silverstein MD, Bozic KJ. The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. J Bone Joint Surg Anm. 2007 Nov;89(11):2389-97.

[4] Walde TA, Burgdorf D, Walde HJ. Process optimization in navigated total knee arthroplasty. Orthopaedics. 2005 Oct;28(10 Suppl):s1255-8.

[5] van der List JP, Chawla H, Joskowicz L, Pearle AD. Current state of computer navigation and robotics in unicompartmental and total knee arthroplasty: a systematic review with meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2016 Nov;24(11):3482-3495.

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