Orthopedic Surgery, Robotics and Regenerative Medicine: What Changes for Patients

Increasing life expectancy is accompanied by a growing prevalence of age-related conditions, including osteoarthritis. At the same time, orthopedics now offers increasingly advanced surgical techniques and treatments. For people living with hip or knee problems, however, the key questions are very practical: which options can improve quality of life, and what outcomes can patients reasonably expect?

We discussed these topics with Dr. Mario D’Errico, an orthopedic surgeon at the Joint Reconstructive Orthopedics Unit of the Orthopedic Clinic (O.R.A.C.O.) at Istituto Clinico San Siro and at the Orthopedics and Traumatology III Unit of Istituti Clinici Zucchi in Monza. Specializing in hip and knee surgery, his work focuses primarily on the surgical treatment of osteoarthritis affecting these joints.

Minimally Invasive Techniques and Robotic Surgery

Minimally invasive techniques are among the developments that have had the most direct impact on the patient experience. “Minimally invasive surgery is an approach that is, and should be, part of every orthopedic surgeon’s daily practice. It has become a routine aspect of our work,” D’Errico explains. “Minimally invasive techniques have transformed the patient experience by significantly reducing recovery times. Because they cause less trauma to the surrounding tissues, they allow patients to recover more quickly and, in many cases, to be discharged from hospital much sooner.”

In some cases, following joint replacement surgery, patients can be discharged as early as the following day and quickly begin their recovery process.

Another important development is robotic surgery, which D’Errico believes should be considered primarily for the contribution it can make to surgical precision. “Robotic surgery should not be regarded as a way to speed up the procedure,” the doctor explains. “Instead, it should be seen as a quality assurance tool for the patient. It provides confidence that the implant will be positioned with a high degree of precision and, above all, in a consistent and reproducible manner. This helps minimize the risk of errors and ensures greater accuracy in the surgical outcome.”

The availability of technology does not make a surgeon’s expertise in conventional techniques any less important. It is essential for every surgeon to have a solid command of traditional surgical methods, as Dr. D’Errico emphasizes: “Every surgeon who uses robotic technology, as I do, must also have an in-depth knowledge of traditional surgical techniques and be able to perform them safely. After all, we are dealing with technology, and technical issues or malfunctions can occasionally occur. For this reason, it is essential to always be prepared to switch to conventional techniques whenever necessary.”

Osteoarthritis and Unhealthy Lifestyles

Alongside advances in surgical procedures, what happens before surgery becomes necessary is equally important. When discussing hip and knee osteoarthritis and meniscal injuries, D’Errico draws attention to lifestyle and the importance of staying active and avoiding sedentary habits.

“With an unhealthy lifestyle and insufficient physical activity—particularly considering the growing focus today on load management, controlling physical demands and therapeutic exercise—the scientific literature shows that movement and gradually getting a joint accustomed to movement can help patients feel better.”

Regenerative medicine is another treatment option that has attracted increasing attention. However, the term itself can create expectations that do not accurately reflect what currently available treatments can achieve.

“Regenerative medicine, particularly through treatments such as PRP (platelet-rich plasma), obtained from a peripheral blood sample, and the use of mesenchymal cells extracted from adipose tissue through a minor liposuction procedure, should not be regarded as a true cartilage regeneration therapy,” D’Errico explains.

Many patients expect these treatments to regrow or rebuild cartilage. According to the doctor, however, their main effect is related to the modulation of inflammatory processes.

“Regenerative medicine,” Dr. D’Errico continues, “which is often associated with the concept of ‘stem cells,’ creates a favorable biological environment that helps better control joint inflammation and improve tissue conditions, contributing to the patient’s overall well-being.”

Today, these discussions often take place with patients who have already researched their condition extensively online. Knowing that a particular technique exists, however, is not enough to determine whether it is appropriate for an individual patient. For D’Errico, helping patients interpret what they have read and understand their own treatment pathway is an integral part of the physician’s role.

“Today we know that when patients place their trust in their healthcare professional and are able to establish an empathetic relationship with them, they can better understand their condition and work together with their doctor throughout the recovery process,” the doctor concludes. “This allows patients to approach their treatment journey with greater peace of mind and confidence, even when pain does not disappear immediately or unexpected issues arise along the way.”