AI and robotics are helping make knee surgery in Croatia more precise, safer, and better for patients. What used to be a manual, one-size-fits-all approach is evolving into personalized, data-driven care.
While many clinicians are part of this shift, in Croatia, Doc. Dr. Sc. Mladen Miškulin is vocal about how AI is changing orthopedic practice, especially in knee surgery. His insights reflect both local adoption and the broader direction of the field.
Integration of AI and Robotics in Knee Surgery
Personalized planning through AI
AI tools analyze imaging (X-ray, CT, MRI) to build a 3D dynamic model of a patient’s knee, not only in static posture, but under load and during movement. This allows surgeons to “simulate” the operation, select optimal implants, and foresee alignment or soft-tissue challenges.
Precision execution with robotic assistance
During surgery, robotic or AI-assisted systems guide bone cuts, ligament balancing, and implant placement. These systems act like a co-pilot, executing planned trajectories while allowing the surgeon to maintain control. Such assistance reduces deviations and improves reproducibility.
Postoperative monitoring and feedback
After the procedure, digital tools (wearables, apps, sensors) monitor joint range, loading forces, gait symmetry, and rehabilitation progress. AI can flag deviations or complications early, prompting timely clinical intervention.
Orthobiology and AI synergy
Beyond implants, Miškulin also discusses orthobiology, using stem cells, plasma, or one’s own tissues for cartilage repair or ligament regeneration. In the future, AI might guide when and where to apply these biological therapies, complementing mechanical reconstruction
Confirmed Robotic Use in Croatia
In Akromion (Zagreb), the ROSA Knee System (Zimmer Biomet) has been installed and is used to assist in knee replacement surgeries. The system offers precise bone resections and soft tissue feedback, helping surgeons execute the plan with accuracy.
Arithera (Zagreb) – Dr. Miškulin’s base, where personalized implants and AI-aided planning are being adopted.
In Županijska bolnica Čakovec, plans are underway to introduce the VELYS Robotic-Assisted Solution for total knee replacement. This system is designed to provide high precision, intraoperative adaptability, and alignment control tailored to patient anatomy.
KBC Split – robotic surgery center
At KBC Split, the Hugo RAS system is already in use for various robotic-assisted surgeries. Though not yet confirmed for knee replacements, it may pave the way for future expansion into orthopedic knee surgery.
Why It Matters
Greater accuracy, fewer errors
Robotic systems can enforce boundaries around safe cuts and implant placements, reducing misalignment and uneven loading.
Customization to the individual
Because each knee is anatomically unique, combining AI planning and robotics allows truly personalized intervention.
Faster recovery and reduced trauma
Limited soft tissue disruption, precise cuts, and optimal implant fit contribute to less pain, quicker rehabilitation, and shorter hospital stay.
Surgeon augmentation, not replacement
These technologies do not replace the surgeon but enhance their capabilities, guiding rather than substituting clinical judgment.
Learning and feedback loops
As more surgeries are performed, AI can learn from outcomes, refine models, and improve future planning.
