CORI ROBOT FAQS

Frequently Asked Questions

What is the CORI Surgical System?

• The CORI Surgical System uses handheld robotics-assisted technology that helps your surgeon plan and perform your unique procedure. This robotics-assisted approach is efficient and more accurate than traditional knee surgery. 4-8
• The CORI Surgical System is a hand-held, radiation-free system that provides experienced surgeons with enhanced surgical planning and robotics-assisted cutting tools designed to ensure optimal implant selection and positioning based on a patient’s unique anatomy.
• Unlike other robotics-assisted platforms, the CORI Surgical System’s real-time planning eliminates the need to undergo a preoperative CT scan thereby reducing patient exposure to potential harmful radiation.
• Can be used with both partial and total knee implants.
• When compared to traditional UKA, Robotics-assisted UKA has a lower risk of revision.5

What is the Ultimate Knee Experience?

• A unique plan
• A wide selection of implants.
• A more natural fit compared to traditional techniques.12,13

What is osteoarthritis?

One of the most common reasons for knee pain is osteoarthritis, also known as “wear and tear” arthritis. 17
Osteoarthritis often requires treatment using either full or partial knee replacement surgery. Generally speaking, as osteoarthritis progresses it causes the smooth cushion between bones (cartilage) to break down. This loss of cartilage can cause your joints to become swollen, hard to move and painful.17

What are some treatment options?

While there’s no cure for osteoarthritis, there are lots of treatment options, including both surgical and nonsurgical options you should discuss with your surgeon. These include:

• Lifestyle changes that can include weight loss and reducing activities that are stressful on your knee
• Physician-prescribed low-impact exercises and physical therapy
• Medications to decrease swelling and provide temporary pain relief
• Surgical options, such as arthroscopic surgery, and partial and total knee replacement.

What is the difference between partial and total knee replacement?

• Most often, partial knee replacement is an option for early to mid-stage knee pain and damage. With this type of knee implant your surgeon replaces the area of your knee that is damaged while keeping the supporting tissue and ligaments that help stabilize your knee.
• Most often, a total knee replacement is an option for advanced knee pain and damage. With this type of knee implant your surgeon replaces the entire knee joint. It’s one of the most common procedures performed in all of medicine.

How does the CORI Surgical System work?

• At the beginning of your surgery, your surgeon uses the CORI Surgical System to create a customized 3D digital model of your knee. This three-dimensional view helps your surgeon finalize and verify the right size implant for you and create a detailed surgical plan for how your replacement will be placed in order to optimize movement and function.
• During the procedure, the CORI Surgical System works in conjunction with your surgeon’s skilled hands to achieve accurate positioning of the knee implant based on your unique anatomy. 7,10,11,18,20,21
• The system sends precise information about your knee to the robotics-assisted handpiece more than 300 times per second, allowing your surgeon to remove damaged surfaces, balance your joint and position the implant with accuracy.7,10,11,18,20,21

•The CORI Surgical System also helps your surgeon perform the procedure as he/she planned it, giving you the combined benefits of the accuracy of robotics assistance and the skill and training of your experienced surgeon.5,6, 8, 10,11 The result is a naturally shaped knee, made from materials designed to last longer, that is positioned with an added level of accuracy to allow for a quicker, smoother recovery*,1,2
• As an added benefit, the 3D digital model eliminates the need to get a CT scan of your knee before your surgery, which reduces your exposure to harmful radiation.

What does it mean to have a natural fit?

• Smith+Nephew implants include designs intended to replicate the shape and motion of your original knee. That means your body can maintain more of its natural rhythm and step. 12,13

Why is a wide implant selection important?

• Knee replacement shouldn’t be a one-size-fits-all. With the CORI Robotics-Assisted Surgical System, your surgeon is able to choose your implant from the widest selection available.14 That means your implant can be matched to feel more like your own knee.
• In addition to its added accuracy, when robotics-assisted surgical procedures are combined with the wide variety of Smith+Nephew implants available, your surgeon is able to choose the implant which best meets your needs, including implant options that allow you to keep more of your natural bone and ligaments, including the ACL.12 That means your body can maintain more of its natural rhythm and step.12,13 You may also regain function faster and get discharged from the hospital sooner as compared to conventional technique surgeries.13
• Only Smith+Nephew knee implants are made with a highly durable material called OXINIUM™ Oxidized Zirconium, which lab testing has shown to better resist wear than traditional knee materials.15

What are CT scans and are they used with the CORI™ Surgical System?

• CT scans or, computerized tomography scans, are a series of images similar to X-rays that show cross-sections of a joint. Other robotics platforms use CT scans to help a surgeon visualize a patient’s knee anatomy. While CT scans are effective at showing the layers of knee anatomy, they can expose the patient to potentially harmful radiation. In fact, a single CT scan is equivalent to the radiation exposure received in 48 chest X-rays.22
• The CORI Robotics-Assisted Surgical System eliminates the need for CT scans by using an advanced computer program to collect anatomic and alignment information about your knee. Once captured, this information is used to build a computer-rendered 3D model of your knee that your surgeon will use to plan your surgery.

What are the risks associated with knee replacement?

• According to the American Academy of Orthopaedic Surgeons (AAOS), the rate of serious complications following knee replacement surgery is very low, under two percent.17 If your health is already challenged by a chronic medical condition, the chance of complication may be greater. If complications occur, they can delay or limit your ability to recover fully from your surgery.
• Some of the complications that can occur include, but are not limited to, blood clotting (Thrombophlebitis), infection, pneumonia, long term pain, knee stiffness, implant wear or failure, and nerve or vascular complications.

Important Note

• Individual results may vary. There are risks associated with any surgical procedure including CORI-enabled Knee Replacement. A CORI procedure is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that limit control of the knee joint, and morbidly obese patients and patients contraindicated for UKR, PFA and TKA should not undergo a CORI procedure. Consult your physician for details to determine if CORI is right for you.

Citations

* Partial knee replacement vs conventional techniques

**1. 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. 2019. 11(Suppl 2):S239-45

2. 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 † n=28 (n=11 robotic procedures)

3. Al-Shaer DS, Ayoub O, Ahamed NA, Al-Hibshi AM, Baeesa SS. Cerebral fat embolism syndrome following total knee replacement causing a devastating neurocognitive sequelae 2016 Jul; 21(3): 271-274

4. Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship.J Robot Surg.

5. Batailler C, White N, Ranaldi FP, et al. Improved implant position and lower revision rate with robotic assisted unicompartmental knee arthroplasty.Knee Surg Sports Traumatol Arthrosc.2019;27:1232.

6. Herry Y BC, 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.

7. Gregori A, Smith JR, Picard F, Lonner JH, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery (CAOS) 15th Annual Meeting; 2015; Vancover, Canada.

8. 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(4):723-9

9. Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Why Are Total knee Arthroplasties Failing Today?Clinical Orthopaedics and Related Research.2002;404:7-13

10. Bollars P, Boeckxstaens A, Mievis J, Janssen D. The Learning Curve and Alignment Assessment of an Image-Free Handheld Robot in TKA: The First Patient Series in Europe. Poster presented at: 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery. 2019; New York, USA.

11. Kopjar B, Schwarzkopf R, Chow J, et al. NAVIO Robotic Assisted Surgical System for Total Knee Arthroplasty Using JOURNEY II Guided-Motion Total Knee System. Poster presented at: ISTA 2-5 October, 2019; Toronto, Canada.

12. 00225 V3 JOURNEY II Design Rationale 11.17.

13. Shearman AD, et al. Robotic-assisted unicondylar knee arthroplasty is associated with earlier discharge from physiotherapy and reduced length of stay compared to conventional navigated techniques. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain Partial knee replacement vs conventional techniques; ‡ n=62 (31 robotics)

14. Smith+Nephew 2020. Comparison of the number of available implants for robotic-assisted knee arthroplasty systems. Internal Report. EO.REC.PCS015.001.v1

15. Heyse TJ, Chen DX, Kelly N, et al. Matched-pair total knee arthroplasty retrieval analysis:Oxidized zirconium vs. CoCrMo. The Knee. 2011;18:448-452.

16. Papannagari R, Hines G, Sprague J and Morrison M. Long-term wear performance of an advanced bearing knee technology. ISTA, Dubai, UAE, Oct 6-9, 2010

17. https://orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-knee/ accessed 3.25.2021

18. Gregori A, Picard F, Bellemans J, Smith JR, Simone A. Handheld Precision Sculpting Tool for Unicondylar Knee Arthroplasty. A Clinical Review. Poster presented at: 15th EFORT Congress;4-6 June, 2014; London, UK

19. Geller JA, Rossington A, Mitra R, Jaramaz B, Khare R, Netravali NA. Rate of learning curve and alignment accuracy of an image-free handheld robot for total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.

20. Mitra R, Jaramaz B, Nikou C, Kung C. Accuracy Assessment of a Novel Image-Free Handheld Robot for Knee Arthroplasty in Bi-Cruciate retaining knee and total knee replacement – A Cadaveric Study. World Arthroplasty Congress;2018; Rome, Italy.

21. Kaper BP, Villa A. Accuracy and Precision of a Handheld Robotic-guided Distal Femoral Osteotomy in Robotic-assisted Total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain

22. Ponzio DY, Lonner JH, Preoperative Mapping in Unicompartmental Knee Arthroplasty Using Computed Tomography Scans Is Associated with Radiation Exposure a…, J Arthroplasty (2014)

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