A team in Singapore has developed an AI-powered algorithm crafted to enhance robotic total knee replacement (rTKR) procedures.
The innovation has obtained an international Patent Cooperation Treaty (PCT).
Created by an orthopaedic surgery team at Alexandra Hospital, the algorithm optimises implant positioning by integrating patient-specific anatomical characteristics with individual surgical philosophies.
The Singapore patent, filed in October 2023, marked a significant milestone.
Robotic-assisted total knee replacement surgeries have been gaining traction due to their potential to enhance surgical outcomes.
However, challenges remain in achieving optimal implant positioning, which is essential for postoperative biomechanical function, patient comfort, and overall surgical success.
The manual planning process currently employed by rTKR surgeons can be complex, requiring intricate consideration of multiple degrees of freedom, often resulting in variability in outcomes.
The newly developed algorithm offers a compelling series of features designed to address the challenges associated with manual planning:
- Enhanced accuracy: Achieving a planned positioning accuracy of ±0.5mm, personalised to each patient’s unique anatomy and the surgeon’s preferred technique.
- Computational efficiency: The algorithm can compute thousands of permutations in just 0.1 seconds, providing optimal solutions for implant placement.
- Reduced surgical duration: By minimising intraoperative planning time, the algorithm significantly shortens overall surgical duration, facilitating a more efficient use of operating room resources.
A prospective study involving 67 rTKR patients from 2021 to 2023 highlighted the algorithm’s remarkable effectiveness:
- Accuracy: 92% of surgeries using the algorithm achieved the surgeon-defined target gaps within ±1.5mm, compared to only 52% in the manual planning cohort.
- Time efficiency: The AI-assisted group realised optimal gap balancing in under 0.1 seconds, markedly quicker than the 15 minutes required by the manual planning group, which included necessary adjustments such as redoing bone saw cuts.
- Consistency: The algorithm demonstrated consistent performance regardless of patient variables such as age, gender, height, or the severity of knee degeneration.
- Surgical productivity: Procedures employing the algorithm were completed approximately 48% faster than those reliant on traditional planning methods.
These findings indicate a substantial increase in surgical accuracy and efficiency, which may lead to reduced blood loss, shorter anaesthesia durations and overall enhanced patient safety and outcomes.
The research underpinning this innovative solution has received accolades at prominent scientific forums, including the prestigious P Balasubramaniam Award for the best research paper at the 2024 Singapore Orthopaedic Association Annual Scientific Meeting.
It has been selected for presentation at the 2024 International Society for Technology in Arthroplasty Scientific Congress in the USA and the 2025 ISAKOS Congress in Germany.
Dr Glen Liau Zi Qiang led the team, with medical students Dr Matthew Ng Song Peng and Mr Ryan Loke Wai Keong.
