title: Robotic and navigation systems in orthopaedic surgery: how much do our patients understand?
abstract: BACKGROUND
  Technology in orthopaedic surgery has become more widespread in the past 20 years, with emerging evidence of its benefits in arthroplasty. Although patients are aware of benefits of conventional joint replacement, little is known on patients' knowledge of the prevalence, benefits or drawbacks of surgery involving navigation or robotic systems.
  
  
  METHODS
  In an outpatient arthroplasty clinic, 100 consecutive patients were approached and given questionnaires to assess their knowledge of navigation and robotics in orthopaedic surgery. Participation in the survey was voluntary.
  
  
  RESULTS
  Ninety-eight patients volunteered to participate in the survey, mean age 56.2 years (range, 19 to 88 years; 52 female, 46 male). Forty percent of patients thought more than 30% of National Health Service (NHS) orthopaedic operations involved navigation or robotics; 80% believed this was the same level or less than the private sector. One-third believed most of an operation could be performed independently by a robotic/navigation system. Amongst perceived benefits of navigation/robotic surgery was more accurate surgery (47%), quicker surgery (50%), and making the surgeon's job easier (52%). Sixty-nine percent believed navigation/robotics was more expensive and 20% believed it held no benefit against conventional surgery, with only 9% believing it led to longer surgery. Almost 50% would not mind at least some of their operation being performed with use of robotics/navigation.
  
  
  CONCLUSIONS
  Although few patients were familiar with this new technology, there appeared to be a strong consensus it was quicker and more accurate than conventional surgery. Many patients appear to believe navigation and robotics in orthopaedic surgery is largely the preserve of the private sector. This study demonstrates public knowledge of such new technologies is limited and a need to inform patients of the relative merits and drawbacks of such surgery prior to their more widespread implementation.
authors.affiliation: Department of Trauma and Orthopaedics, University College London Hospital, London, UK.
authors.forename: Shivan S
authors.initials: SS
authors.lastname: Jassim
authors.affiliation: Department of Trauma and Orthopaedics, University College London Hospital, London, UK.
authors.forename: Harry
authors.initials: H
authors.lastname: Benjamin-Laing
authors.affiliation: Department of Trauma and Orthopaedics, University College London Hospital, London, UK.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Douglas
authors.affiliation: Department of Trauma and Orthopaedics, University College London Hospital, London, UK.
authors.forename: Fares S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D032882:Comprehension; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000523:psychology*; D065287:Robotic Surgical Procedures / Q000523:psychology; D025321:Surgery, Computer-Assisted / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Arthroplasty; Navigation; Patients; Robotics; Survey