The knee is a complex and very important joint of the body. Almost every basic activity in our day-to-day life like walking, climbing or descending stairs, sitting on chair or even standing still depends on a well-tuned system of knee bones, ligaments, cartilage, muscles, and nerves. If there is a permanent damage to any structure in the knee, or if age related degenerative conditions such as osteoarthritis, or another condition affect your knee, you may need a knee replacement surgery.
Knee replacement is a surgical procedure where the damage articular surfaces of the knee bones are removed using specialised tools and replaced with artificial metal components. It is imperative that this surgery is performed with extreme precision so that not only the damaged parts are removed and replaced with corresponding prosthesis, but they are also implanted in appropriate orientation within the body. Therefore, extreme accuracy is paramount in these procedures. The more exact a surgeon's measurement tools, the better they can plan and perform your surgery.
Robotic knee surgery represents a cutting-edge technology that aids surgeons in performing highly accurate partial or total knee replacement procedures. This advanced approach customizes the surgery to each individual's unique anatomy, ensuring optimal results.
What is Robotic Knee Replacement?
A robotic knee replacement is very much similar to a conventional total knee replacement. The robotic knee replacement surgeons removes damaged tissue in your knee and replaces it with an artificial metal prosthesis. The preoperative preparation and most of the pre-surgical workflow remains the same, however the significant difference is that once the incision on the skin and soft tissue dissection is done, the further procedure is done with assistance from a robotic arm, which allows for greater accuracy is executing the procedure. A robotic-assisted knee replacement offers a greater soft tissue balance around your knee thereby equalising the compartmental pressures and it also better aligns the joint.
In summary, having a robotic-assisted knee replacement surgery doesn’t need you to prepare differently as compared to your preparation for a conventional total knee replacement surgery.
At Joints & Sports Clinic Mumbai, Dr Chirag Patel will discuss all knee replacement options available to you, including whether you are a good candidate for robotic joint replacement.
How do Robotic Knee Replacements Work?
At Joints & Sports Clinic, Dr Chirag Patel has access to the most advanced cutting-edge robotic tools that are used to help your surgeon create and execute an ideal knee replacement for you, which optimises every step of your surgery. Various types of robotics surgical systems (Mako/ROSA/Velys/Cuvis) are available and can be used in both partial knee replacement and total knee replacement surgeries.
Before a robotic knee replacement surgery, you will be advised to undergo a series of specialised scans (X-ray and CAT Scan) which help to create a 3-D image of your knee joint, bone structure, and surrounding tissues. This clear image helps your surgeon plan every step of your surgery with precision. The damaged structures are outlined with the 3-D imaging and then bone cuts are planned and executed to remove the damaged surface with precision to the millimetre.
Once the bone cuts are reshaped with the aid of the robotic arm, the further planning is mimicked onto the robotic arm to pick the right implant size and positioning. This is followed by a trialling of the appropriate implants and confirming the accuracy of the surgical steps thus far. If the execution is satisfactory, the knee is implanted with the final prosthesis after assessing the range of motion and stability of the knee.
At the beginning of a robotic-assisted surgery, your surgeon will use tracking pins to help the robot confirm that it received correct size and positioning information from your CAT scans. Next, the robotic arm aligns itself, and your surgeon uses a hand-held tool to carry out your knee replacement. The robotic tools will guide the surgeon throughout the procedure, enhancing their experience and skills. Please be aware that robotic tools are not error free and it is the skill and experience of the operating surgeon which directs the robotic arm to perform and execute the total knee replacement surgery. The robotic arm is only a tool and does not replace the skills and experience of the operating surgeon.
Who is a Candidate for Robotic Knee Replacement?
If you are a candidate for traditional knee replacement, it is likely you are a candidate for robotic-assisted knee replacement, as well. Robotic knee replacements are great for treating even the most challenging knee problems, such as:
- Femur deformities from past injuries.
- Severe joint wear and tear.
- Metal implants from previous surgeries.
What are the Advantages of Robotic Knee Replacement Surgery?
There are several advantages of robotic-assisted knee replacement surgery when compared with traditional surgery. Advantages include:
- Enhanced surgical planning: Specialised 3-D images taken in preparation for and during surgery help your surgeon more accurately plan the optimal type and placement of your replacement joint to ensure the right size and fit.
- Better accuracy: Robotic technology boosts your surgeon's skill, allowing for more precise planning, tissue removal, and implant placement.
- Optimal joint alignment: With robotic technology, your surgeon is able to better align and position your knee implant as well as tension the surrounding structures appropriately to equalise the compartmental pressures in the knee joint. This helps ensure a more natural-feeling joint replacement and create less friction and wear on your new joint.
A Robotic Knee Replacement gives a knee joint that is well-aligned, stable and specifically has minimal errors (that can occur in patients who have unique anatomical variations). More precise knee replacement and the ability to create a customised surgical plan, choose the ideal implant sizes before surgery and execution to near perfection gives more satisfaction post-operatively in day-to-day functioning of the knee joint.
Traditional vs. Robotic Surgery for Knee Replacements
Robotic-assisted knee replacement surgery isn't performed by a robot alone. Instead, the robot acts as a guide, helping your surgeon follow a pre-planned approach.
Just like in traditional surgery, your orthopedic surgeon remains in control but uses the robot as an additional tool. This technology supports your surgeon throughout the procedure to ensure the best results.
Robotic Knee Replacement Recovery Process
Robotic joint replacement makes smaller cuts and improves positioning. The goal is to take advantage of the robotic precision to enhance your recovery thereby improving your quality of life and long-term mobility.
After your surgery, your surgeon and team will track your progress, manage any discomfort, and create a personalized recovery plan, including a tailored rehabilitation program for your home. The ultimate objective after robotic knee replacement surgery is to restore your independence and to get you home safely at the earliest.
Moving after Robotic Knee Replacement
After your robotic knee replacement surgery, you will be encouraged to get up and move as soon as it is practical and safe and depending on how you are feeling. Our orthopaedic recovery team will assist you in walking short distances with crutches or a walking frame.
Managing Pain after Robotic Knee Replacement
Our pain management team uses unique multimodal pain management system which allows us to better manage post-surgery pain throughout every step of your recovery to reduce the need for pain medications and narcotics.
Length of the hospital stay
The length of your stay in the hospital following robotic knee replacement depends on many factors that your surgeon will discuss with you to determine the best option for you. Most patients can expect to spend two nights in the hospital before being discharged to begin recovery.
Preparing for Home and Rehab after Knee Replacement
On the day you go home, we will prepare you with all of the information and direction you'll need during recovery, including:
- Incision care
- Medications
- Required follow-up visits
- Restrictions (i.e., no driving, working or showering)
