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You’ve probably heard of knee replacement, a surgery that is conventionally offered to patients with knee arthritis (joint degeneration), and you’re probably wondering what a robotic knee replacement is, as well as how it differs from a regular knee replacement surgery.
In this article, we will be sharing all about this cutting-edge surgery, from its benefits to its long-term results for patients, to help you make a more informed decision.
If you have arthritis of the knee and it is causing you a significant amount of pain, affecting your quality of life, or limiting your ability to carry out daily activities, then you’ll likely benefit from a knee replacement.
Osteoarthritis is a very common condition, especially in the elderly, and is due to many years of wear and tear on the cartilage in the knee joint. It can be treated conservatively with physiotherapy, knee braces and painkillers, but if the pain persists, knee replacement surgery becomes the mainstay of treatment.
As the name suggests, a knee replacement involves removing the damaged areas of your knee joint and replacing it with a prosthetic implant, which effectively removes knee pain and restores your function. A prosthetic knee implant generally lasts for up to 15-20 years and beyond, but this may vary depending on your activity level and usage of the knee joint.
There are two main modalities with which knee replacement surgery can be carried out: the traditional method and the robot-assisted surgery. There are several robot-assisted knee replacement systems, and the robotic systems commonly used locally include Mako (Stryker), ROSA (Zimmer Biomet), and NAVIO (Smith & Nephew). All three systems employ robotic technology to assist the surgeon in precisely shaping your knee to fit the knee replacement implants and accurately restoring the stability and alignment of your limbs. Depending on the robotic system, both total knee replacement and partial knee replacement surgery can be performed.
A robotic knee replacement does not mean that the entire surgery is done by a robotic arm. The surgeon is still critically involved in every step of the surgery – the surgeon performs every part of the operation, with the robot assisting in ensuring precise and accurate execution of each step. This ensures that the patient benefits from both the skill, experience and judgement of the surgeon, as well as the reliability and reproducibility of the robot.
Prior to the surgery, X-rays (and sometimes CT scans) of your affected knee will be done, and a 3D computer model of your knee joint will be created. This allows the surgeon to visualise the anatomy of the knee joint and the overall limb alignment, and to create a detailed and bespoke pre-operative plan prior to the surgery. The robot will then assist in ensuring that the plan is precisely carried out during the operation.
Your surgeon will use a robotic surgical arm to carry out selected parts of the procedure, especially those requiring high precision and fine movements. The robot assists the surgeon in making extremely precise cuts in your bone, helps to verify that your implants are inserted at the correct position with the best fit to your knee, and ensures that your knee is stable and optimally aligned (“straight”).
There are numerous benefits of opting for a robotically-assisted knee replacement over the non-robotic/traditional method, such as:
As with any surgery, there are inherent risks; however, the potential problems mentioned below are relatively rare, and the advent of robotic surgery may further decrease some of these risks.
With the precision and fine control of the robotic arm, the risk of nerve and vessel damage is reduced compared to traditional surgery.
Deep vein thrombosis (DVT) is a side effect of prolonged bed rest after surgery, but since robotic knee replacement is associated with less pain and faster recovery, you can expect to walk sooner and reduce the risk of DVT.
As robot-assisted knee replacement allows for smaller incisions and less soft tissue injury, the risk of wound breakdown and prosthetic joint infections can be reduced.
Utilising the precision of the robot, the risk of inadvertent intra-operative fractures is markedly lowered.
The accuracy and precision of robot-assisted knee replacement provides for optimal implant fit, positioning and alignment, which can potentially lead to better longevity of your knee replacement.
In a traditional knee replacement surgery, the surgeon relies on mechanical guides and his own experience to make the requisite bone cuts and position the knee implants, usually without any highly accurate means of verification. During the traditional operation, a large vertical incision is made along the front of your knee, after which the surgeon decides on the appropriate size of the knee implant and manually measures & removes the amount of bone required to fit the implant. Once the implant has been fitted, the surgeon visually assesses the alignment, stability and movement of your new knee joint before completing the operation.
Robot-assisted knee replacement involves similar steps to the traditional method, but the bone cuts are made together with the robot for higher accuracy and precision, and the robot further provides reliable verification of implant fit, position, stability and alignment. This allows the surgeon to reliably reproduce optimal outcomes and potentially better long-term results for
While robotic surgery does have some additional benefits over the traditional method, both of these surgical modalities for knee replacement can greatly improve your quality of life.
Ultimately, the aim of knee replacement surgery is to relieve the pain and functional impairment caused by knee arthritis.
Do see your doctor if you have painful knee arthritis and are considering knee replacement surgery. You can consult with your surgeon if robot-assisted knee replacement surgery is the best option for you.
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