Robotic knee surgery: what you need to know

A Mediclinic specialist explains the basics and benefits of robot-assisted (robotic) knee surgery.

Dr Craig Solomon, an orthopaedic surgeon at Mediclinic Gape Gate, was among the early adopters of robotic knee replacement surgery, performing the procedure when it was still relatively uncommon. “Over time, I began to use robotic assistance more frequently,” says Dr Solomon, who specialises in complex and revision hip and knee replacements.

“I prefer to use a robot for every joint replacement because the surgical technique is more accurate and precise compared to conventional surgery,” he adds. “With robotic surgery we can now do patient-specific knee replacements.”

What is robotic knee surgery?

In robotic knee replacement, advanced imaging technology is used to provide the surgeon with an accurate 3D model of the patient’s knee. “This includes images of the bony anatomy, the soft tissue characteristics, and how the joint is aligned,” explains Dr Solomon. “With the 3D model, the surgeon can plan the whole operation to ensure a perfect knee replacement. This information is then transferred to the robot. During the surgery, the robot ensures the procedure is executed precisely as intended.”

The robot employs real-time tracking technology throughout the operation. The surgeon places sensors above and below the patient’s knee, which the robot detects using multiple cameras. This setup allows the robot to monitor the knee's position and the surgeon's tools, ensuring the surgery aligns with the preoperative plan.

The surgeon uses a robotic handheld device, such as a saw or burr, to perform the surgery. “In robot-assisted knee surgery, the surgeon remains in control, but the robot helps to minimise errors. It prevents the surgeon from deviating from the plan, for instance, by restricting how far I can burr or saw,” says Dr Solomon.

The benefits of robotic assistance

Robotic knee surgery has several benefits for both patients and surgeons. The biggest advantage is its accuracy, which is within a fraction of a millimetre, according to Dr Solomon. Another key benefit is that the procedure is tailored to each individual patient.

“A conventional knee replacement aims for a mechanical alignment of the replacement and is more of a one-size fits all approach. In contrast, robotic surgery allows for a personalised, patient-specific solution to joint replacements,” says Dr Solomon. He adds that about one in five patients who undergo traditional knee replacement surgery are dissatisfied after the procedure, which indicates that there’s room for improvement.

“With robotic joint replacement surgery, we use a kinematic alignment method that helps restore a patient’s knee to its original shape and function before the arthritis set in. In the short and medium term, we’ve seen higher satisfaction rates, less postoperative pain, and quicker hospital discharge,” he says.

Sometimes patients can be discharged from the hospital on the same day as their surgery, though this often depends on the level of support available at home. Faster discharge times for patients who undergo robotic knee surgery, compared to those who have traditional knee surgery, are due to the kinematic alignment approach, which protects soft tissue and results in less pain after surgery.

As robotic technology continues to evolve, it’s becoming an increasingly valuable tool in joint replacement surgery. The greater precision and faster recovery after surgery give patients a better quality of life sooner.

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