Robotic-assisted total knee replacement uses a computer-guided system to plan the operation on the individual patient’s anatomy and to execute the bone cuts with a high degree of accuracy. At the Major Joints Clinic this is performed with the ROSA Knee system developed by Zimmer Biomet.
Before surgery, calibrated radiographs or a CT scan are used to build a three-dimensional model of the knee and to plan implant size, position and limb alignment. In theatre, optical trackers registered to the femur and tibia allow the system to follow the exact position of the bones in real time. The robotic arm then positions the cutting guides according to the plan. Throughout the operation the surgeon remains in control and can adjust the plan at any point; the robot assists, it does not decide.
The part of knee replacement that has always been hardest to quantify is ligament balance. The ROSA system measures the gaps between the femur and tibia in extension and flexion, and displays how they change as the knee is moved. The surgeon can therefore adjust bone resection by a millimetre or a degree and see the effect on balance immediately, instead of relying on feel alone. A well-balanced knee is more stable, feels more natural and tends to be less painful.
Studies consistently show that robotic assistance reduces outliers in component alignment and limb axis compared with conventional instrumentation, and reduces the need for soft-tissue release. Early functional scores and length of stay favour robotic-assisted surgery in several series. Long-term survival data are still maturing, and it is fair to say that a well-performed conventional knee replacement also gives excellent results. Robotics improves consistency; it does not replace surgical judgement.
Patients with significant deformity, previous fractures or retained hardware, unusual anatomy, or those undergoing partial knee replacement, where implant positioning is particularly unforgiving, gain the most from robotic guidance. It is equally applicable to routine primary total knee replacement.
Recovery follows the same fast-track pathway as conventional knee replacement: mobilisation on the day of surgery, discharge within two to four days, crutches for two to four weeks and return to daily activity over six to twelve weeks. Robotic assistance does not lengthen the operation appreciably in experienced hands, and the incision is the same as for standard surgery.
Robotic assistance adds to the cost of the procedure, and cover varies between insurers. The overall price also depends on implant choice, hospital, length of stay and anaesthesia. Contact the practice for a personalised estimate.
to guide you about your condition, to choose the best possible treatment.
