BPH Launches Collaborative Robot & Data App for Total Knee Arthroplasty

InFocus Issue 22, January 2022

Brisbane Private Hospital has just installed the first ROSA collaborative robot in theatre for total knee arthroplasty in the Brisbane CBD area, to assist surgeons with greater precision, workflow planning and adjusting soft tissue tension around the knee joint.

Used by Dr Gauguin Gamboa and Dr Tyson Doneley, the ROSA Robotic system offers an accurate model of the knee through special pre-operative imaging to deliver precision planning, with further adjustments during surgery after measurement of soft tissue tension. The robot navigation also allows for detailed measurements and data collection.

Orthopaedic surgeon Dr Gamboa, who has a special interest in hip and knee surgery, said the robotic system allowed for the improved assessment of the tension of ligaments and integrates both bone and soft tissue data in the surgical planning.

“While the new platform doesn’t change the way we do our surgery, the integration of navigation and use of the robotic arm allows for seamless execution of the detailed planning. The increased precision reduces the need for recutting and minimises the variation between the plan and the actual executed bone resection.

“Excitingly, the new technology also collates patient’s intraoperative data and then has the ability to subsequently correlate this to their clinical outcomes. This opens the opportunity for the information to be used as guidelines for future surgical recommendations. The clinical data, which is likely to be integrated into our national joint registry in the next two to three years, can greatly assist with clinical research that may guide orthopaedic surgeons of the future.”

Hip and Knee Surgeon Dr Tyson Doneley said the technology also assisted with pre-operative simulation, bringing a fine level of detail to surgical planning and workflow. The robotic arm allows surgeons to make fine adjustments of the bone cuts in surgery to 0.5mm and 0.5 degree precision levels.

“Normal navigation can also deliver these results, but this robotic system makes these adjustments straightforward.

“One of the key benefits are the simulations of surgery and predictions we can make beforehand. This systemises our pre-planning and allows us to better plan the instruments or implants we will need in detail, which can help to cut down on waste and increase the efficiency of instrumentation in theatre. Pre-op planning also allows for complex or non-routine cases, e.g. following trauma to be modelled and simulated to reduce chances of intra-operative issues.”



Dr Doneley said the National Joint Replacement Registry has reported that doing navigated surgery and using computer alignment tools benefits the longevity of a knee replacement, due to the assisted accuracy in reducing outliers. 

“The consistency of the robot, or other navigation systems keeps the spread of outliers narrow and reduces unintended outlier results. Going forward, it also offers an opportunity for us to better determine what makes a knee replacement work well, so the data collection for patient outcomes is very good.”

Drs Gamboa and Doneley will use the ROSA robotic system in combination with the Mymobility app that educates, monitors and assists patients undergoing knee replacements on every step of their journey. In combination these systems create a strong data collection and storage platform.

Mymobility collaborates with a patient’s data and history to take them through an interactive, customised plan and journey and stores their detailed information in one database. Tailored to each surgeon and patient, it contains procedure education; outlines required prehabilitation; explains pain management; monitors the wound and recovery; and provides rehabilitation exercises and assessment via an app.

“The app is provided to patients via an Apple watch for Apple-users or an android-phone-compatible app, which collects and delivers continuous data and feedback to help facilitate patient care and results.

“Both technologies are exciting to introduce to Brisbane Private Hospital, to benefit the patient journey and the data collection that is so essential to refining and improving patient outcomes.”