Robotic knee replacement: What you need to know

Knee replacement surgery has evolved significantly over the years, with robotic knee replacement emerging as a cutting-edge option for patients with severe knee arthritis and knee pain.

Mr Juan Agustin Soler Fernandez, renowned consultant orthopaedic hip and knee surgeon, provides a comprehensive overview of robotic knee replacement, addressing key questions for patients considering this advanced surgical technique.

How does robotic knee replacement differ from traditional knee replacement?

Enhanced planning: Robotic knee replacement uses advanced imaging and computer modelling to generate a detailed 3D map of the knee. This model helps the surgeon to plan the operation with greater accuracy, taking into account the unique anatomical features and alignment needs of the patient’s knee.

Precision and accuracy: Robotic-assisted surgery utilises advanced technology to enhance the surgeon’s ability to plan and carry out the procedure. The robotic system creates a 3D virtual model of the patient’s knee, allowing for a highly personalised surgical plan. During the surgery, the robotic arm assists the surgeon in precisely positioning the implant, ensuring optimal alignment and fit.

Real-time feedback: In robotic-assisted surgery, the robotic system provides real-time feedback and guidance, helping the surgeon make precise adjustments during the operation. This real-time data enhances the surgeon’s ability to achieve optimal outcomes.

What pre-surgical evaluations are necessary for robotic knee replacement?

Before undergoing robotic knee replacement, patients must undergo a series of medical evaluations to determine their suitability for the procedure. These evaluations typically include:

• Comprehensive medical history: A detailed review of the patient’s medical history, including previous surgeries, chronic conditions, and any medications.
• Physical examination: A thorough physical examination to assess the overall health and condition of the knee.
• Imaging studies: Advanced imaging techniques, such as CT scans or MRIs, are used to create a detailed 3D model of the knee.

Additionally, patients must follow specific pre-surgical preparations to ensure a successful outcome. These preparations typically include:

• Medication adjustments: Some medications, particularly blood thinners and anti-inflammatory drugs, may need to be adjusted or discontinued before surgery.
• Pre-surgical exercises: Physical therapy or exercises to strengthen the muscles around the knee can improve post-surgical recovery.
• Lifestyle modifications: Patients may be advised to make lifestyle changes, such as quitting smoking or losing weight, to reduce surgical risks and improve healing.

How is robotic knee replacement performed?

The patient is given anaesthesia to ensure comfort during the procedure. This may be general anaesthesia (putting the patient to sleep) or regional anaesthesia (numbing only the lower half of the body).

During robotic knee replacement, the surgeon makes an incision over the knee to access the joint. The damaged cartilage and bone are then carefully removed. The robotic system, controlled by the surgeon, assists in precisely removing the damaged tissue and preparing the bone for the implant. The robotic arm helps guide the surgeon's movements, ensuring accurate bone cuts and implant positioning.

The knee implant is then positioned according to the personalised surgical plan. The robotic system provides real-time data and feedback, allowing the surgeon to make precise adjustments as needed. This capability ensures that the surgical plan is executed with high precision, even if there are variations in the knee's condition during the procedure. Once the implant is securely in place, the surgeon closes the incision with sutures or staples.

After the surgery, the patient is monitored in a recovery room before being transferred to a hospital room or discharged home, depending on their condition. Pain management, wound care, and early mobilisation are essential components of post-surgical care.

How is robotic knee replacement customised to fit my specific knee anatomy and condition?

The customisation process begins with the detailed 3D model generated during the pre-surgical evaluations. Using this 3D model, the surgeon develops a personalised surgical plan tailored to the patient's specific needs which includes information about:

• Optimal implant size and position: The 3D model helps the surgeon determine the best size and position for the implant, ensuring a natural fit and alignment.
• Customised bone cuts: The robotic system guides the surgeon in making precise bone cuts based on the patient's anatomy, improving the accuracy of the implant placement.
• Alignment and balancing: The personalised plan ensures proper alignment and balancing of the knee joint, which is crucial for the implant's long-term success and functionality.

Will I need physical therapy after?

Physical therapy is a crucial component of the recovery process after robotic knee replacement. It helps restore strength, flexibility, and function to the knee, ensuring a successful outcome. Physical therapy can also reduce pain and swelling, improve mobility, and prevent complications such as blood clots.

A physical therapist will design a personalised rehabilitation program tailored to the patient's specific needs and progress. The therapist will guide the patient through exercises, monitor their progress, and adjust the program as needed to ensure optimal recovery.

How long does robotic knee replacement last?

The longevity of a knee replacement, whether traditional or robotic-assisted, depends on several factors, including the quality of the implant, the accuracy of its placement, and the patient's activity level and overall health. On average, knee implants are designed to last 15 - 20 years.

Robotic knee replacement has the potential to enhance the longevity of the implant due to its precision and accuracy. Proper alignment and positioning of the implant can reduce wear and tear, minimising the risk of early failure. This improved accuracy can lead to better long-term outcomes and potentially extend the life of the knee replacement.

Patients can also help maximise the lifespan of their knee replacement by following post-surgical care instructions and maintaining a healthy lifestyle, including adhering to physical therapy, maintaining a healthy weight, avoiding high-impact activities, and attending regular follow-up appointments.

If you would like to schedule an appointment with Mr Juan Agustin Soler Fernandez, head on over to his Top Doctors profile today.