Smith+Nephew launches ‘turn-key’ robotic-assisted surgical system

Smith+Nephew launches ‘turn-key’ robotic-assisted surgical system; designed to quickly augment the orthopaedic team’s skills set for greater accuracy [1-3] ¥ improved outcomes [4], and potentially an immediate scalable solution to NHS  

The CORI system is a compact and fully mobile [5] solution incorporating a 3-D intra-operative imaging system with an advanced robotic sculpting tool. The robotic system allows surgeons to measure, plan, and perform a knee surgery which is personalised to the patient’s individual anatomy in theatre.   

The Smith+Nephew system is considerably more compact [6] than alternative robotic systems*, has minimal set up time, and is so portable** it can be moved from theatre to theatre to optimise flow of patients through surgical units. 

One of the first surgeons to use the device in the UK, Mr Tim Parratt, Consultant Orthopaedic Surgeon at East Suffolk North Essex NHS Foundation Trust says, “The CORI system is excellent to use. This technology is mobile, portable and slots seamlessly into theatre. There is minimal disruption for the theatre staff.  If anything, it’s easier than getting conventional kit ready. This system also allows me to tailor the operation to the patient’s unique physiology, whereas with instruments I tended to perform the same operation every time on each patient.” 

Patient Outcomes: Less pain, fewer revisions, and greater satisfaction post-surgery 

 Over 680,000 people are currently waiting for a hip or knee replacement [7]. Many of those have waited well over a year, living with chronic pain. More than 10 per cent of patients waiting for knee surgery in the UK say their quality of life is ‘worse than death’ [8].  

The benefits of robotics-assisted surgery for patients are myriad, and include significantly improved patient reported outcome measures (PROMs) [9,10] †‡ and shortened length of hospital stay11‡, there is evidence of an earlier return to an active lifestyle [12]‡. 

Australia has been a leader in the field of robotics and navigation in orthopaedic surgery and the registry has demonstrated the benefits patients can expect such as fewer revisions [13] and complications [13], and a shorter length of hospital stay with the patient able to be discharged in sub-24 hours. [14] 

“The CORI system enables every patient to have a knee replacement that is shape matched and aligned to their specific anatomy. We know that outcomes aren’t consistent in non-robotic surgeries and that one in five patients [15-20] have issues following surgery. Our technology has evolved so that we can achieve a personalised fit to each individual patient,” says Mr Simon Tarry, Managing Director, UK, Ireland & Nordics, Smith+Nephew. 

Innovation at Smith + Nephew 

The CORI system is amongst the first technology to place the surgeon at the heart of the digital operating room. Surgeons can access the benefits of robotic surgery but still have full decision-making capability at each step of the operation. 

This system is the first of several launches in technology and software over the next five years, demonstrating Smith and Nephew’s commitment to improve surgical experience through digital and technology innovation across the patient pathway.  

To learn more about Smith + Nephew’s CORI surgical system please visit: www.robotics-surgery.com 

References:

1. Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assistedunicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27:1232-1240. 
2. Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic assisted  surgical technique. Int Orthop. 2017;41:2265-2271. 
3. Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. Preliminary experience with an image-free handheld robot for total knee arthroplasty: 77 cases compared with a matched control group. Eur J Orthop Surg Traumatol. 2020;30:723-729. 
4. Nherera LM, Verma S, Trueman P, Jennings S. Early economic evaluation demonstrates that noncomputerized tomography robotic assisted surgery is cost-effective in patients undergoing unicompartmental knee arthroplasty at high-volume orthopaedic centres.  Adv Orthop. 2020;3460675. 
5. Smith+Nephew 2020. CORI and NAVIO Technical Specification Comparison. Internal Report. ER0488 REV B. 
6. Smith+Nephew 2020. Comparison of operating room footprint for robotic-assisted knee arthroplasty systems. Internal Report. EO.REC.PCS015.002.v1.  
7. LCP, (14 September 2021), ‘NHS Waiting List Tracker’, https://nhswaitlist.lcp.uk.com/ (accessed: 14 September 2021). 
8. Clement, N. D., Scott, C. E., Murray, J. R., Howie, C. R., Deehan, D. J., & IMPACT-Restart Collaboration. (2021). The number of patients “worse than death” while waiting for a hip or knee arthroplasty has nearly doubled during the COVID-19 pandemic: a UK nationwide survey. The Bone & Joint Journal, 103(4), 672-680. 
9. Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018; 138(12):1765-1771. 
10. Chen K, Kim K, Vigdorchik J, Meere P, Bosco J, Iorio R. Cost-effectiveness analysis of robotic arthroplasty. Lonner JH, editor. Robotics in Knee and Hip Arthroplasty: Springer; 2019 
11. Sephton BM, Bakhshayesh P, Edwards TC, Ali A, Kumar Singh V, Nathwani D. Predictors of extended length of stay after unicompartmental knee arthroplasty. J Clin Orthop Trauma. 2020;11(2)S239-45. 
12. Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018; 138(12):1765-1771. 
13. Richard N. de Steiger, Yen-Liang Liu, Mapp and Stephen E. Graves. Computer Navigation for Total Knee Arthroplasty Reduces Revision Rate for Patients Less Than Sixty-five Years of Age. Journal of Bone and Joint Surgery. Vol 97-A, Number 8. April 15 tats, 2015. 
14. Sephton BM, De la Cruz N, Shearman A, Nathwani D. Achieving discharge within 24h of robotic unicompartmental knee arthroplasty may be possible with appropriate patient selection and a multi-disciplinary team approach. J Orthop. 2020;19:223-228. 
15. Banerjee S, Cherian JJ, Elmallah RK, Jauregui JJ, Pierce TP, Mont MA. Robotic-assisted knee arthroplasty. Expert review of medical devices. 2015;12(6):727-735. 
16. Urish KL, Conditt M, Roche M, Rubash HE. Robotic Total Knee Arthroplasty: Surgical Assistant for a Customized Normal Kinematic Knee. Orthopedics. 2016;39(5):e822-827. 
17. Nodzo SR, Carroll KM, Mayman DJ. Disposable Navigation for Total Knee Arthroplasty. Am J Orthop (Belle Mead NJ). 2016;45(4):240-245. 
18. Abdel MP, Oussedik S, Parratte S, Lustig S, Haddad FS. Coronal alignment in total knee replacement: historical review, contemporary analysis, and future direction. Bone Joint J. 2014;96-B:857–62. 
19. Stiehl JB, Komistek RD, Cloutier JM, Dennis DA. The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. J Arthroplasty. 2000;15:545-550. 
20. Moro-oka TA, Muenchinger M, Canciani JP, Banks SA. Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2007;15:93-99. 

Staff Writer