Robotic Knee Arthroplasty

Occasional knee pain is common among people. However, if the pain is intense, interferes with everyday activities, or comes with swelling, redness, or warmth, consulting a doctor is advisable.

At Complete Orthopedics, our dedicated team of knee experts provides various knee pain treatments, including surgical options when necessary. We serve patients in New York City and Long Island across six hospitals, offering exceptional surgical and orthopedic care. You can schedule an appointment with our surgeons either online or by phone.

Discover the typical reasons for knee pain and explore the available treatment options, including circumstances where surgery is recommended.

Overview

Robotic knee replacement surgery is a surgery that is performed to replace an arthritic knee (or some other condition that has led to a degenerative joint disease within the knee). The surgery itself is performed by a surgeon with the assistance of a robot with a built in computer system that allows for more precise calculations of where bony cuts need to be made in order to remove the arthritis fully from the patients knee. It also allows a slightly smaller incision size and slightly more conservative tissue dissection due to the highly precise nature of the robotic assistant.

Symptoms

Knee arthritis can be a very painful condition that interferes will everyday activities, work and recreational sports. The vast majority of patients who suffer from knee arthritis will be candidates to have robotic-assisted knee replacement surgery. The indications for this are essentially the same as normal knee replacement surgery that is not assisted by a robot. Pain in the knee that is frequent, severe and debilitating. Ideally the patient should also have a full assessment by an orthopedic surgeon including an examination and assessment of plain-film radiographs.

Provided that the patient’s examination and plain-film radiographs demonstrate degenerative joint disease and the patient’s symptoms coincide with this, that patient will be considered a candidate for a knee replacement. The only contraindication to a patient receiving a knee replacement from procedure that uses robotic assistant would be severely abnormal anatomy or any other severe deformity that precludes the use of the sophisticated computer-navigating software.

Treatment

The procedure of replacing a patient’s knee using robotic assistance is broadly similar in terms of the surgical approach and equipment that is used. The procedure will involve bringing in a robot to calculate the position and depth of the bony cuts necessary in order to complete the surgery successfully. The robot itself does not complete the surgery and is under the control of the surgeon the entire time. The computer software the robot uses builds a 3-dimensional image of the knee based on reference points given to it by the surgeon using separate “navigational pins”. These can be placed inside the surgical field, or using separate small incisions which you may notice after the surgery.

Once the 3D image is built, the computer then calculates the exact position of the cuts needed to remove the arthritis from the bone, and the robotic arm makes the cuts in the exact position calculated with input from the surgeon using it. The parts of the procedure such as closure of tissue planes and closure of the skin incision are still up to the surgeon to do on his/her own.

Duration

You will experience some postsurgical pain in the area that has been operated on after your knee replacement. This is normal and you will be prescribed medications by your surgeon to attempt to control your pain and bring it within tolerable levels. It is important to remember that, at this stage, it is unrealistic to expect that there will be no pain and so a small amount of soreness in and around the knee is normal. It will take one to two weeks for the postsurgical pain to dissipate; however, this does not indicate that the knee has fully healed.

There will be some discomfort in the knee up to around 6 weeks following the surgery and in some patients, this may even persist up to 3 months following the surgery. The pain is caused by a number of factors including the muscles around the knee recovering from the surgery and regaining strength that they have lost, as well as other tissues around the knee healing and getting used to the new biomechanics of the knee joint.

It is also important to remember that a small subset of patients even experience pain up to and beyond 6 months and even a year following the surgery and that this is not necessarily an indication that the knee replacement has failed. Pain that lasts long after the surgery can be for a number of reasons and it is important to communicate your experience of this pain with your surgeon accurately so that they can best direct any therapeutic intervention in your ongoing care.

Benefits of Robotic-Assisted TKA

Patients who undergo robotic-assisted knee replacements often experience several benefits:

• Improved Accuracy: Enhanced alignment and placement of the knee implant.
• Quicker Recovery: Patients typically report faster recovery times and return to daily activities.
• Reduced Pain and Complications: Precision in surgery minimizes tissue trauma, which can lead to reduced postoperative pain and lower risk of complications.
• Longevity of Implant: Accurate placement and alignment can potentially extend the life of the implant.

Considerations and Challenges

While the advantages are compelling, there are considerations that patients and surgeons must bear in mind:

• Cost: Robotic-assisted surgeries can be more expensive due to the technology and training required.
• Availability: Not all medical facilities have access to robotic surgery systems.
• Learning Curve: Surgeons must undergo specific training to operate these sophisticated systems effectively.

Recovery

Recovering from a robotic knee replacement involves a structured process to ensure the best outcomes and a smooth return to everyday activities. This type of surgery uses robotic-assisted technology to achieve more precise placement of the knee implant, which can lead to better joint function and longer implant life. Here’s an overview of the recovery process:

Immediate Postoperative Period (0-1 week)

• Hospital Stay: Most patients stay in the hospital for 1 to 3 days after surgery. During this time, pain management is a priority, typically through medications.
• Mobility: Patients are encouraged to move their knee as soon as possible after surgery with the help of physical therapy. This includes standing and walking with assistance within the first 24 hours.
• Wound Care: The surgical site must be kept clean and dry. Dressings are usually changed by medical professionals, and instructions are given for care at home.

Early Recovery Period (1-6 weeks)

• Physical Therapy: Regular sessions with a physical therapist are crucial. The focus is on reducing swelling, improving leg strength, and increasing range of motion.
• Home Care: Patients will need help at home for several weeks. It’s important to prepare living spaces to avoid falls, including removing loose rugs and ensuring good lighting.
• Pain Management: Pain and swelling are normal but should gradually decrease. It’s important to follow the prescribed pain management plan.

Intermediate Recovery Period (6-12 weeks)

• Rehabilitation: As healing progresses, more intense strengthening exercises and walking become integral parts of rehabilitation.
• Gradual Return to Activities: Patients can typically start returning to most daily activities, though high-impact activities should still be avoided.
• Follow-Up Visits: Regular check-ups with the surgeon are essential to monitor the progress and address any concerns.

Long-Term Recovery (3 months and beyond)

• Continued Improvement: Full recovery can take up to a year. Joint function and strength continue to improve over several months.
• Activity Resumption: Patients can gradually return to more strenuous activities, including sports, as guided by the healthcare team.
• Long-Term Care: Long-term follow-ups may be recommended to monitor the implant and overall joint health.

Lifestyle Adjustments

• Exercise: Continuing with a regular, moderate exercise regimen is important to maintain strength and flexibility in the knee.
• Weight Management: Keeping a healthy weight can reduce pressure on the knee and extend the life of the implant.
• Diet: A balanced diet rich in calcium and vitamin D can help maintain bone strength.

The use of robotic technology in knee replacement generally leads to a quicker and more effective recovery compared to traditional methods, due to the precision of the surgery. However, the commitment to follow the recovery plan and attending all scheduled therapy sessions are key factors that influence the outcome.

Summary

Given that most patients who suffer from knee arthritis and who would like to pursue a knee replacement as a treatment option would likely be candidates for robotic-assisted knee replacement surgery, it is something that you can ask your orthopedic surgeon or healthcare provider about. We will be happy to discuss the possibility of you receiving a knee replacement assisted by a robotic device and answer any questions or concerns you have with regards to this particular treatment option.

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