Tartu hospital tests robotic knee surgery, but funding remains uncertain

Tartu University Hospital has carried out its first robot-assisted knee operations in a pilot project, but it is not yet clear whether Estonia’s Health Insurance Fund will pay for the system, ERR reported. The hospital covered the weeklong trial and doctors’ training itself.

The CORI system creates a digital 3D model of the joint without X-rays or CT scans. A marker is used to map the damaged joint, and a milling tool can then be used during knee replacement surgery. Orthopaedic clinic head Kaspar Toots stressed that the robot cannot operate without a surgeon.

Toots said knee replacement results are already good without robotic assistance, but 15 to 20 percent of patients still have some concern after surgery. The technology could help improve results for those patients. Orthopaedic surgeon Kaarel Kiiranen, who performed or assisted with eight or nine of the operations, said the system could be particularly useful in more difficult cases.

The robot could cost nearly 1 million euros. Sensors and a milling tool would add about 800 euros per operation, while the use of manual instruments would fall by around 300 euros, Toots said. Kiiranen said the system offers surgeons more confidence in the outcome, but at a higher cost.

The Health Insurance Fund would not currently cover the new system. It has an innovation fund for new treatments, including systems such as CORI, but Tartu University Hospital has not applied for support. Toots said the system could also be valuable for training at the hospital, which he described as Estonia’s only institution educating doctors. He added that there is not yet precise evidence on how effective CORI is.