Robotic Total Knee Replacement

Knee replacements are constantly advancing in how we position them with the aim of giving patients the best long term results, and technology evolves to make sure we do this as accurately as possible.

Implant positioning must be linked in with the ligament balance of the knee to get the best outcome. In years gone by we used to put knee replacements in a standard set position for everyone, but now we are putting knee replacements in patient customised positions based on what the individual knee looked like before arthritis set in. This more modern kinematic functionally balanced alignment seems to be giving better results and a more balanced knee, which leads to greater satisfaction and less pain.

To ensure we get the ligament balance and implant replacement right we use modern technology with the Mako robot. Prior to surgery we get a CT scan to ensure we get a virtual 3 Dimensional model of your own personal knee, as well as its relationship to the centre of the hip and ankle, before planning custom virtual positioning of the joint replacement. During surgery we look at the preoperative plan and adjust it slightly depending on how tight or loose the ligaments are within the knee at various positions. We then make sure that only the essential bone is removed and the implants are positioned very accurately with robotic guidance. The haptic boundaries also mean that the saw cuts are constrained to only take away the bone required for the implants, with the aim of less damage to the soft tissues, so less pain. There are multiple papers suggesting less pain, less rehabilitation and a shorter hospital stay when compared to instrumented knee replacements.

After surgery we would expect you to be in hospital 2-3 days, walking with crutches until weeks 2-3, a single stick for support until week 6, then walking without aids. Most of the discomfort and swelling will have resolved by week 4, but won’t completely settle until 3-4 months. Physio is important following a knee replacement to help you get your range of motion and for early reduction of swelling.