Knee replacements using AI at Villa Erbosa: ‘tailor-made’ surgery
Artificial intelligence is revolutionising knee replacement surgery, paving the way for increasingly personalised and effective procedures. Leading this change is the Villa Erbosa Clinic in Bologna of the San Donato Group, one of the first centres in Europe to have adopted AI in this field. Professor Gennaro Pipino, head of one of the facility’s orthopaedic units, takes stock of this development.
Traditional approaches and limitations
To date, prosthetic surgery has relied on manual instruments capable of performing mechanical or kinematic alignments. “A purely mechanical alignment offers stability in extension and at mid-flexion-extension, whilst a kinematic alignment ensures stability during movement but risks leaving the centres of gravity not fully active,” explains Prof. Pipino.
Artificial intelligence overcomes this dichotomy: “It manages to combine the best of kinematic and mechanical alignment, resolving the limitations of manual methods. In this way, an ideal balance and significantly superior joint performance are achieved”.
Artificial Intelligence in Knee Replacement Surgery
One of AI’s most innovative contributions lies in its ability to process pre-operative data and numerical parameters that are invisible to the human eye. “AI provides us with extremely precise guidance to ensure compliance with mechanical and kinematic requirements, enabling us to perfectly centre the knee’s centre of gravity,” emphasises the specialist.
Centring the centre of gravity means performing a “state-of-the-art” implant procedure, with tangible benefits for the patient’s quality of life: by drastically reducing wear rates, the prosthesis lasts much longer, restoring a natural, fluid and immediately comfortable joint.
How the operation changes
“The operation is tailored to the patient’s anatomical characteristics,” emphasises Professor Pipino. AI generates a bespoke virtual plan for each patient, much like a ‘bespoke suit’. From this plan, personalised surgical templates are created to guide the specialist’s hand during the operation.
The clinical benefits are clear: the procedure is quicker, more precise and less invasive. This translates into less blood loss, a drastic reduction in post-operative swelling, a lower risk of infection and, consequently, a much faster recovery.
An ‘adolescent’ AI guided by the surgeon’s experience
Despite the great strides that have enabled it to overcome the rigid limitations of traditional robotic surgery, artificial intelligence remains a fundamental support tool and not a substitute for the doctor.“
We can describe AI as a technology that is still in its ‘adolescence’, learning day by day from the analysis of clinical cases,” explains Prof. Pipino; “it provides valuable data, but the final decision and surgical planning remain firmly in the hands of the specialist. It is like driving a racing car with steering wheel controls: the technology is highly advanced, but a highly experienced driver is needed to know how to control it and adapt it to each individual case.”
At Villa Erbosa, technology is a tool within a broader, multidisciplinary approach, in which clinical experience and attention to the individual patient remain central.
