Robotic total knee replacement is where the techniques for surgery are combined with robotic technology. The use of robotic technology during surgery allows surgeons to benefit from the precise robotic movements for surgery that demands accuracy. For a robotic knee replacement, Sydney residents can benefit from an individualised surgical plan based on their specific anatomy.
CT scans of the knee are performed before surgery to enable a 3D model to be constructed of the knee anatomy. This forms a base to the surgical plan. The 3D modelling guides knee replacement component size and position of placement in the knee.
During surgery, the anatomic landmarks are registered to the computer operating system using a probe with sensors, and the computer navigation software directs the knee replacement components to the position that matches both the bone and tissue anatomy of the knee.
Robotic technology does not replace the orthopaedic surgeon. The surgeon remains in control throughout the operation through decision making and then performing the surgery. The robotic arm surgical tool operated by the surgeon removes the arthritic bone in preparation for the knee replacement components that are then inserted.
Robotic knee replacement surgery forms one part of a successful treatment plan to alleviate knee pain and restore function. Pre-operative and post-operative physiotherapy are also important parts to the treatment plan. The physical therapy exercise programme is tailored to your needs and goals. The physiotherapist will guide the return of knee movement and strength with these also serving to reduce post-operative pain and potentially also to reduce post-operative complications.
Robotic knee replacement surgery is classified as major surgery and the first few weeks after surgery can be physically and psychologically challenging. Take time to settle back into home, and work towards routine home activities. Post-operative soreness is to be expected and can be managed with pain-relieving medication. Tiredness can also be expected.
The operated knee is expected to swell. The knee swelling and warmth should reduce slowly over a couple of months. Ice packs are excellent ways to control swelling and also pain. Pain control is important as it will allow you to follow the exercise programme and to enable rest. Remember to follow the pain management plan as this will hopefully allow a return to your usual sleep pattern.
A waterproof dressing covers the surgical incision. The dressing is shower proof, is changed only when required, and can be removed and left off 2 weeks after surgery. The sutures to the surgical incision are dissolvable and do not require removal. Thereafter, the surgical scar can be gently massaged with moisturising skin cream/bio-oil/vitamin E cream.
Regular light exercise such as walking is encouraged, and work towards returning to routine household activities as comfort and confidence permits. It may however be a couple or few months before recreational activities are returned to.
The journey after a robotic knee replacement can extend for several months and, in the early weeks, progress may seem difficult to judge, however successful treatment is measured by the long-term result.
Dr Robert Sew Hoy is an Orthopaedic Surgeon with nearly 20 years of experience in treating hip and knee conditions. Dr Sew Hoy completed subspecialty training in hip and knee replacement surgery at the Harvard Medical School in Boston, and then at the Mater Hospital in Sydney. His results can be judged by the satisfaction of patients treated.
Dr Robert Sew Hoy’s experience and success have allowed him to provide his services in two convenient locations:
- Northern Beaches Hospital
Suite 20, Level 7, 105 Frenchs Forest Road, Frenchs Forest, NSW 2086
- The Mater Clinic
Suite 1.15, 3-9 Gillies Street, Wollstonecraft, NSW 2065
Dr Robert Sew Hoy focuses exclusively on hip and knee conditions, promising to provide a comprehensive personalised treatment plan for each and every patient.
Some of the most frequently asked questions are answered below.
Robotic knee replacement surgery is safe. It is however important to spend time understanding the potential risks and complications of knee replacement surgery.
Clinical protocols and pathways are followed that have been designed to reduce risk, but risk cannot unfortunately be reduced to zero. The vast majority of patients proceed through surgery along the expected path to recovery. It is important however to spend some time reading through the potential risks and complications, and to ask questions as they arise.
A list of the more important risks includes, but are not limited to:
- Infection of the components and this is despite administering medication to prevent infection.
- Blood clots (termed venous thromboembolism), and this is despite administering medications to prevent blood clots.
- Numbness around the surgical incision.
- Failure of the component to bond to the bone termed component loosening.
- Knee stiffness despite diligence with the rehabilitation programme
And importantly, the potential for residual pain despite completion of the rehabilitation programme and having restored knee movement and function. The residual pain after knee replacement surgery shall hopefully be significantly less than the pain from arthritis present before surgery.
Most patients will go home after 3-5 days in hospital but, for patients in their mid-70s and above, this may depend on whether there is someone home with them and whether there are only a couple of pre-existing medical conditions, or many pre-existing medical conditions. Prior to going home, patients need to prove their reasonable independence with regards to personal care, namely toileting, showering, dressing, walking safely with walking aids, and managing stairs.
The physiotherapy plan is designed to regain knee joint function and to a return to routine daily activities through a balance of exercise and rest. Pain-relieving medication and ice packs work towards reducing knee pain and swelling. Discomfort around the knee replacement should become more manageable overtime. Work with the physiotherapist to find a balance between exercise and rest.
Pain and discomfort caused by orthopaedic conditions affect our patients negatively every day. Which is why we work so hard to provide relief for every one of our patients. Our team is highly trained in the diagnosis, treatment and management of all musculoskeletal conditions and injuries.