Robotic Total Knee Replacement

What Happens During Robotic Knee Replacement?

Before undergoing robot-assisted knee replacement surgery, the orthopedic doctor will conduct a physical examination. Following this, they prescribe diagnostic and imaging tests, including X-Ray, MRIs, bone scans, etc., to find the full extent of knee joint damage and determine the most appropriate treatment option for you.

It is very important to undergo complete diagnosis because the robotic arm uses these diagnostic images as a reference while making incisions for the surgery. If these images are not taken, there could be a complication or wrong incision during the surgery.

Normally, robotic knee replacement is performed under spinal or regional anesthesia but general anesthesia can also be used during the surgery. Barring complications, most patients are discharged from the hospital on the same day.

You will be admitted to the hospital on the day of the operation. After this, a nurse will check your vital signs to ensure you are healthy enough to undergo surgery. Then you will be anesthetized and moved to an operation theater. 

The surgical process remains very similar to the traditional total knee replacement surgery. However, the orthopedist will use a robotic arm to make the incisions and perform the surgery. The surgeon will make the incision and remove damaged parts of the knee joint.

Then, they will affix the implant in its place and close the incisions. The robotic arm will help the surgeon avoid unnecessary trauma to the surrounding tissues and provide a quicker recovery period. The chances of potential complications will also reduce drastically. 

What are the Different Types of Knee Implants for Robotic Knee Replacement Surgery?

The implants for robotic knee replacement are similar to traditional knee replacement surgery. Normally, a knee implant has 3 components, i.e., the femoral component, tibial component, and patellar component. However, in the case of complex robot-assisted knee replacement, the implant may have additional components or may be modified to allow for better movement after the surgery.

Knee replacement implants are made of plastic and metal components. The plastic components of the implant are made of polyethylene, while the metal component is usually made of cobalt-chromium, titanium, zirconium, and nickel. 

Based on the components used, an implant can be categorized into four categories, i.e., metal on plastic, ceramic on plastic, ceramic on ceramic, and metal on metal implants. Your orthopedic surgeon will discuss your treatment and prosthetic options with you and help you decide the best prosthesis for you.

What to Expect After Robotic Knee Replacement Surgery?

Overall, the patient will recover knee mobility and function sooner after the surgery. Moreover, there will be minimal scarring and a shorter hospital stay. However, to ensure this, the patient needs to follow proper rehabilitation protocols.

Since the surgery is usually performed under regional anesthesia and involves so little tissue damage, most patients can go back home on the same day. They will start walking with an assistive device, like a stick, cane, or walker, on the same day. The patient may be able to start walking without support after 2-3 weeks.

Rehabilitation generally lasts for 12 weeks but can take longer if needed. The patient may have to wait 5-7 days for their tensions to close before they can shower. They should wait at least 3-4 weeks before swimming, bathing, etc., to avoid soaking the wound. The patient will notice a significant improvement in joint strength and range of motion within 4-6 weeks of physiotherapy.  

What are the Benefits of Robotic Knee Replacement Surgery?

There are many advantages of robotic-assisted knee replacement surgery over traditional knee replacement, such as:

• Better surgical planning: Before robotic surgery, your orthopedic surgeon will take specialized 3-D images of the operative site to prepare the robotic arm for your operation. These images will help them customize the placement of the incisions and the size of the implant to ensure the implant fits absolutely correctly for you.
• Greater surgical precision: Robotic surgery will compliment your surgeon’s expertise, i.e., they will be able to use the arm to make even smaller and more accurate incisions allowing for less soft tissue damage. 
• Easier to make adjustments: During robotic surgery, your surgeon can make micro-adjustments to the bone and implant using 3D software. Normally, such adjustments are not even visible to the naked eye. Thanks to these changes, the implant will fit better, provide better movement, and there will be very little chance of implant dislocation in the future.
• Reduced chances of re-surgery: As described above, robot-assisted knee replacement has better implant positioning and provides a better fit. Therefore, your surgeon can adjust the size, position, and rotation of the implant precisely to avoid complications that can lead to the necessity for revision replacement in the future. 
• Faster recovery with fewer chances of complications: Robotic knee replacement surgery has a quicker recovery period compared to traditional or arthroscopic knee replacement techniques. Moreover, since the cuts formed by the robotic arm are so precise, the chances of complications like bleeding, infection, etc., become even lower. 
• Spares the ligaments surrounding the knee: Due to the accuracy of the robotic device, the patient gets more options for ligament-sparing during total knee replacement surgery. This allows for better joint movement after recovery and is great for athletes, gymnasts, etc., i.e., patients with more requirements of knee joint function.

How to Improve Recovery After Robotic Knee Replacement?

If you’ve just undergone robotic knee surgery, then you can aid your recovery by followingthe given tips:

• Don’t bend or twist the operated knee joint for at least a few days. You can wear a knee brace to prevent strain on your joint. 
• Take your medications as prescribed and follow your physiotherapy routine without fail.
• Avoid strenuous activities like running, gym exercises, lifting heavy objects, etc., to avoid straining the prosthetic before it has healed completely.
• If you need other surgeries, then don’t schedule any other procedures before you have recovered.
• Avoid smoking and drinking during the recovery period to prevent complications.
• Use ice packs to massage the operated area 4-5 times a day for at least 3-4 days to reduce postoperative swelling. 
• Eat a healthy diet to avoid constipation and boost the immune system.

What are the Risks and Complications Associated with Robotic Knee Replacement Surgery?

Robotic surgery is the safest option for knee joint replacement surgery. Even though it is very safe, in rare cases, some complications may occur during or after the surgery, such as:

• Anesthesia-related complications
• Infection or bleeding
• Blood clots formation in the deep veins
• Failure to resolve pain and other symptoms
• Nerve or artery damage
• Allergic reaction to the implant or failure of the implant to integrate