Introduction

Knee replacement surgery is a proven way to relieve pain and restore movement when arthritis or injury damages the joint. Today, many surgeons use robotic-assisted technology to perform both partial knee replacement (when only part of the knee is damaged) and total knee replacement (when the whole joint needs to be replaced). This technology is designed to make surgery more precise and recovery smoother.

What is Robotic-Assisted Surgery?

Robotic-assisted knee replacement does not mean a robot performs your surgery. Instead, your surgeon is fully in control at all times and uses advanced robotic tools and 3D planning software to:

• Create a personalized surgical plan.

• Place the implant with improved accuracy.

• Adjust the plan during surgery as needed.

 

1. Planning and visualization: A preoperative CT scan of your knee is loaded into the software to create a 3D model, which helps us create an exact plan for how much bone to remove and where to position the metal implants. The model appears on a monitor during the surgery, and using technology called arrays, we create constant landmarks on the femur and tibia and register the actual bone with the virtual model. Therefore, when we move and flex the leg during surgery, the landmarks stay constant, and the robot continues to “see” the leg.

The surgeon operates the robotic arm.

 

2. Personalized adjustments: Using the 3D software, we can make micro-adjustments to the planned bone cuts – something the naked eye couldn’t see – to achieve a perfectly balanced knee.

 

3. Safety and precision: The robotic arm and preoperative plan are synced up, and the arthritic portions of the bone appear as a green field on the 3D model. Guiding the robotic arm, the surgeon removes the arthritic bone. Haptic technology, which is highly sensitive to touch, ensures the surgeon only removes the designated area, virtually eliminating the risk of damaging healthy bone, ligaments, and other surrounding tissue.

Arthritic bone slated for removal is in green.

 

4. Pinpoint positioning: During the procedure, we test the implants for size, position, and rotation before making them permanent. The Mako robot provides precise coordinates for the implant and can confirm that the gaps on the inside and outside of the knee remain the same throughout the arc of motion. The result will eventually be a knee that moves seamlessly with appropriate balance.

Benefits:

1. Personalized Fit

The system uses detailed imaging of your knee to help your surgeon create a surgical plan that matches your unique anatomy. This can improve how the implant feels and functions.

2. Greater Precision

Robotic tools guide your surgeon to place the implant in the exact position planned. Accurate alignment may lead to:

• More natural knee movement.

• Longer-lasting results.

3. Less Tissue Damage

Because the system allows for smaller, more precise cuts, there may be:

• Less damage to surrounding tissues.

• Reduced blood loss during surgery.

4. Faster Recovery

Some patients may experience:

• Less pain right after surgery.

• Quicker return to walking and daily activities.

5. Better Outcomes for Partial Knee Replacement

In partial knee replacement, precision is especially important because only one part of the knee is being resurfaced. Robotic assistance can help ensure the implant fits well and works smoothly with the rest of the joint.

Things to Keep in Mind

• Robotic-assisted surgery may not be necessary or suitable for every patient.

• Long-term results are promising but similar to traditional techniques—both are highly successful.

• Your surgeon’s training and experience remain the most important factor in your outcome.

Conclusion

Robotic-assisted knee replacement is an exciting advancement that can offer patients a more personalized procedure, with potential benefits in precision, recovery, and comfort. Talk with Dr. Cone to see if this technology is the right choice for you.

References

1. Marchand, R. C., Sodhi, N., Anis, H. K., Ehiorobo, J. O., Newman, J. M., & Mont, M. A. (2019). One-year patient outcomes for robotic-arm-assisted versus manual total knee arthroplasty. Journal of Knee Surgery, 32(11), 1063–1068.

2. Kayani, B., Konan, S., Huq, S. S., Tahmassebi, J., & Haddad, F. S. (2018). Robotic-arm assisted total knee arthroplasty: A systematic review and meta-analysis. Journal of Arthroplasty, 33(7), 1999–2006.

3. Kort, N. P., van der Graaff, J., & Schotanus, M. G. (2019). Robotic-assisted knee arthroplasty: A systematic review and meta-analysis. Acta Orthopaedica, 90(6), 566–571.

4. Clement, N. D., MacDonald, D., Hamilton, D. F., Burnett, R., & Patton, J. T. (2021). Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: Early functional outcomes and gait analysis. Bone & Joint Journal, 103-B(7), 1130–1137.