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Joint Replacement Surgery / Robotics

Learn more about the surgical options available when considering or researching knee replacement surgery.

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Joint replacement (knee replacement) is required when all or part of a joint is worn out or arthritic. After thorough assessment treatment is tailored to the individual patient.

Surgical options include

  • Partial knee replacement surgery
  • Total knee replacement surgery
  • Joint preservation surgery (for more information see Knee Osteoarthritis treatment page)
  • New – MAKO Robot Assisted Knee replacement surgery (Partial or Total)

When is a knee replacement needed?

Knee replacement surgery is typically considered when other treatments, such as medications, physical therapy, or lifestyle changes, have not been effective in relieving pain or improving function. The decision to undergo knee replacement surgery is typically made after a thorough evaluation, which will include a physical examination, imaging with X-rays, and possibly other diagnostic tests.

Knee replacement surgery is recommended when the knee joint is severely degenerate (Grade IV) and cannot be saved with significant symptoms of pain and reduction in function.

It's important to note that knee replacement surgery is a major procedure and is not appropriate for everyone. Your doctor will consider a variety of factors, including the severity of your knee problems, your age and overall health, and your level of physical activity, when determining whether knee replacement surgery is appropriate for you.

Types of knee replacement surgery:

Total knee replacement (TKR): This is the most common type of knee replacement surgery. It involves replacing both the inner (medial) and outer (lateral) compartments of the knee joint.

This can be done in the conventional way with manual assessments, planning and execution with good results.

However, the latest and most precise way of approaching TKR surgery is using cutting edge Mako Robotic technology. A CT scan is taken of the knee which is used to precisely assess the joint and plan the surgery using the MAKO robot. Please see section on this.

- Unicompartmental or Partial knee replacement: This is a type of partial knee replacement that involves replacing only the inner (medial) or outer (lateral) compartment of the knee. It is typically recommended for people with mild to moderate osteoarthritis that is limited to one compartment of the knee.

- Customised knee replacement: This type of surgery involves using computer-assisted technology to create a prosthesis that is customised to fit the specific anatomy of the patient's knee. It may be an option for people with unusual knee anatomy or for those who have previously undergone knee surgery.

- Revision knee replacement: This procedure involves replacing a previously implanted knee prosthesis. It may be necessary due to wear and tear, infection, or other complications.

We will be able to recommend the best type of knee replacement surgery for your specific case, based on your individual needs and circumstances.

What are the advantages of Robotic knee replacement?

Robotic knee replacement is a surgical procedure in which a robot is used to assist with the placement of implants during a total knee replacement surgery. There are several potential advantages to using a robot for this procedure:

  1. Increased accuracy: The robot is able to make precise cuts and placements of the implants, which may lead to better alignment and function of the replacement joint.
  2. Shorter recovery time: Using a robot may allow the surgeon to complete the surgery with less tissue trauma, potentially leading to a shorter hospital stay and faster recovery.
  3. Reduced pain and scarring: Because the robot is able to make precise cuts, there may be less trauma to the surrounding tissues, potentially leading to reduced pain and scarring after surgery.
  4. Improved range of motion: Some studies have suggested that robotic-assisted surgery may result in improved range of motion compared to traditional surgery.
  5. Reduced blood loss: The robot is able to make precise cuts, which may result in less bleeding during the surgery.

It's worth noting that robotic knee replacement is still a relatively new technology, and more research is needed to fully understand its benefits and potential risks.

What is involved in a Partial Knee Replacement?

This is an operation where only a part of the knee joint is replaced. This is only possible if the wear in the joint is restricted to one compartment. The knee has 3 main compartments:

- Medial tibio-femoral compartment (inside of the knee)

- Lateral tibio-femoral compartment (outside of the knee)

- Patello-femoral compartment (behind the kneecap)

The great advantage of this type of procedure is that only the arthritic part of the joint is resected and replaced, leaving intact all the ligaments and the rest of the healthy knee. The result is a more natural feeling knee.

It is a smaller operation, via a smaller incision and the recovery is generally quicker, and the patients often report that the knee feels like their own knee.

The other advantage is that you can delay having a total knee replacement for as long as the partial replacement still functions well.

After a period of time, usually up to 10 years (sometimes less), the partial replacement becomes loose or the rest of the knee becomes arthritic, and a further operation is required. The next operation is always a Total Knee Replacement.

The main disadvantage of this type of procedure is the unpredictability of how long the prosthesis will function well, and so it is highly recommended that you seek an experienced knee surgeon regularly performing this type of surgery, to get the best possible outcome.

What is involved in a Total Knee Replacement (TKR)?

This is an operation where the whole of the knee joint is exposed via an incision at the front of the knee. The knee dimensions and alignment are measured, and decisions made around how much of the arthritic joint is to be removed. Usually, a minimum amount of bone is removed.

The appropriate sized implants are selected and the new knee surfaces are cemented into place using special bone “cement” (Polymethylmethacrylate – PMMA).

This is a significant operation and appropriate preoperative planning is required to ensure a safe procedure and good outcome for the patient.

TKRs usually last on average around 15 years and provide great pain relief and restoration of knee function.

What is a Mako Robot Assisted Total Knee Replacement?

This is a new evolution in the approach to total knee replacement surgery.

Recent development in robotics and computer software templating has resulted in the development of the Mako robot assisted total knee replacement.

This involves performing a preoperative CT scan of the patient’s knee. The images are loaded onto a special software which the surgeon uses to measure the level of arthritis and perform intensive and intricate preoperative planning of the surgery. This helps to ensure a highly accurate approach two joint replacement surgery.

With the MAKO system, can plan and carry out both:

  • Total Knee Replacement
  • Partial Knee Replacement

The surgeon carries out the incisions to expose the knee joint and the robot as controlled by the surgeon to perform the bone cuts for the operation. The prosthesis is then implanted by the surgeon as usual. 


What are the advantages of Mako Robot Assisted Surgery?:

Some studies have shown:

  • Less bone and soft tissue damage
  • Less requirement for strong analgesics after surgery
  • A reduced length of stay in hospital
  • Lower requirement for inpatient physiotherapy sessions
  • Less post-operative pain

What are the disadvantages of Mako Robot Assisted Surgery?: 

  • Requirement for CT scan pre surgery
  • Slightly longer operative time

What is a robotic knee replacement?

A robotic knee replacement is a type of knee replacement surgery in which a robot is used to assist the surgeon in performing the procedure. During the surgery, the surgeon uses a computer console to control the robot, which is equipped with specialised instruments. The robot is designed to help the surgeon position the prosthetic components of the knee with greater accuracy and precision than is possible with traditional techniques.

Robotic knee replacement surgery is typically done using a minimally invasive approach, which means that the surgeon makes smaller incisions in the skin to access the knee joint. This can result in less pain and a faster recovery time compared to traditional knee replacement surgery.

Robotic knee replacement surgery is still a relatively new technology, and it is not widely available. However, we are very pleased to be able to offer this to our patients.

It's important to discuss the potential benefits and risks of robotic knee replacement surgery with your doctor to determine whether it is a good option for you.

What are the different types of robotic knee surgery?

There are 3 types of robotic-assisted knee surgery that are currently in use:

  1. Robotic-assisted total knee replacement: This is a procedure in which a robot is used to assist with the placement of implants during a total knee replacement surgery.
  2. Robotic-assisted uni-condylaR knee replacement: This is a procedure in which a robot is used to assist with the placement of implants during a partial knee replacement surgery.
  3. Robotic-assisted patella-femoral replacement. This is a procedure in which a robot is used to assist with the placement of implants during a patella-femoral replacement operation.

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