Robotic Total Ankle Is Here

At last week’s AOFAS Annual Meeting in Seattle in Seattle, researchers presented the first data on robot-assisted total ankle replacement (TAR).

The technology in question, TiRobot, is an orthopedic surgical robot whose robotic arm guides K-wire and screw placement using 2D or 3D imaging, with claimed sub-millimeter precision. It’s currently used mainly in spine and trauma surgery. 

The study

The retrospective review of 113 Infinity ankle replacements performed between 2019 and 2023 compared outcomes using TiRobot navigation (42 patients) with conventional guides (71 patients). 

Across the study’s measures, the robotic-navigation group outperformed the conventional-guide group on most fronts:

• Operative time: 85 minutes vs. 112 minutes (P < 0.001)

• Tourniquet time: 68 minutes vs. 95 minutes (P < 0.001)

• Surgeon radiation exposure: down 78% (P < 0.001)

• Wound complications: 4.8% vs. 16.9% (P = 0.045)

• Two-year AOFAS scores and implant survivorship: comparable between groups

Looking ahead

Robotic navigation streamlined workflow, shortened ischemic time, and reduced radiation and early complications without affecting short-term function. The authors suggest it may also improve alignment precision.

Expect other surgeons to follow this shift from patient-specific instrumentation to robotic placement in TAR.