Robotic Knee Replacement

Robotic knee replacement is an advanced form of knee replacement surgery that uses robotic-arm assistance and computer-guided planning to help the surgeon perform the procedure with a high level of precision. The surgery itself is still performed by an orthopaedic surgeon, but the robotic technology assists with planning, alignment, bone preparation, and implant positioning based on the patient’s individual anatomy. At Principle Orthopaedics, MAKO robotic-assisted knee replacement is performed to support accurate implant placement and personalised surgical planning.

What is robotic knee replacement?

Robotic knee replacement is a knee replacement procedure performed with the assistance of a robotic arm system such as MAKO. Before surgery, a CT scan is used to create a three-dimensional model of the patient’s knee. This allows the surgeon to plan the procedure in detail, including implant size, positioning, alignment, and bone cuts. During the operation, the robotic system provides real-time feedback and helps the surgeon execute the plan with a high degree of control and accuracy.

How robotic assistance works

The robotic system does not perform the operation by itself. The surgeon remains fully in control throughout the procedure and uses the robotic arm as a highly sophisticated surgical tool. Tracking technology and computer software help map the knee and guide bone preparation according to the pre-operative plan. The system can also help the surgeon assess alignment, soft tissue balance, and implant position during the procedure so adjustments can be made in real time if needed.

Who may benefit from robotic knee replacement?

Robotic assistance can be used in total knee replacement and in some partial knee replacement procedures. It may be suitable for patients with knee arthritis causing pain, stiffness, reduced movement, deformity, and loss of function when non-surgical treatment is no longer effective. Whether robotic-assisted surgery is appropriate depends on the severity of arthritis, the pattern of knee damage, the type of replacement required, and the individual patient’s anatomy and treatment goals.

When is knee replacement considered?

Knee replacement is generally considered when arthritis-related pain and stiffness are interfering with walking, work, sleep, exercise, or day-to-day activities, and conservative treatment has not provided enough relief. This may include anti-inflammatory medication, physiotherapy, injections, weight management, walking aids, and activity modification. If symptoms remain significant and imaging confirms joint damage, knee replacement may be recommended.

Potential advantages of robotic-assisted surgery

One of the major goals of robotic-assisted knee replacement is to improve the accuracy and consistency of implant positioning. Better precision may help optimise alignment, soft tissue balance, and component placement according to each patient’s anatomy. Potential benefits described with robotic-assisted surgery include more detailed pre-operative planning, improved surgical accuracy, reduced variation in implant positioning, and in some cases improved early recovery and patient satisfaction.

• Three-dimensional CT-based surgical planning.
• More accurate implant positioning and alignment.
• Real-time intraoperative feedback during the procedure.
• Ability to tailor the operation to the patient’s individual anatomy.
• Potential for improved early function and recovery in selected patients.

How the procedure is performed

Robotic knee replacement follows the same overall principles as conventional knee replacement, but with the added support of robotic planning and guidance. The damaged cartilage and bone are removed from the knee joint and replaced with prosthetic components that recreate the joint surfaces. The robotic system helps guide the surgeon in carrying out the planned resections and implant positioning with precision.

A typical robotic knee replacement procedure may include:

• Pre-operative CT scanning to create a three-dimensional model of the knee.
• Detailed surgical planning for implant size, alignment, and positioning.
• Anaesthesia and preparation of the knee for surgery.
• Placement of tracking arrays or markers to register the knee during the procedure.
• Exposure of the knee joint through the surgical incision.
• Use of the robotic system to guide bone preparation within predefined boundaries.
• Balancing of the knee and assessment of range of motion and stability.
• Insertion of the final implants and closure of the wound.

Robotic total knee replacement versus traditional knee replacement

Robotic knee replacement does not change the fundamental aim of surgery, which is to relieve pain and restore function in an arthritic knee. The main difference is the use of computer-guided planning and robotic assistance to support precision during the operation. Traditional knee replacement relies on manual instruments and alignment guides, while robotic systems provide additional data and intraoperative guidance that may help improve consistency in component placement.

Risks and complications

Robotic knee replacement carries many of the same risks as conventional knee replacement, including infection, bleeding, blood clots, stiffness, nerve or blood vessel injury, fracture, ongoing pain, implant loosening, and the possibility of revision surgery in the future. Robotic systems also have technology-specific considerations, such as the use of tracking pins and the possibility of longer operative time in some settings. Your surgeon will discuss the risks relevant to your case and whether robotic assistance is appropriate for your treatment.

Recovery and rehabilitation

Recovery after robotic knee replacement is similar in principle to recovery after standard knee replacement. Patients are usually encouraged to begin moving the knee and walking early after surgery, with physiotherapy playing an important role in restoring movement, strength, balance, and confidence. Many patients improve steadily over the first few weeks, but full recovery continues over a longer period as strength and function return.

A general recovery pathway may include:

• Early mobilisation and walking with assistance.
• Pain management, swelling control, and wound care.
• Physiotherapy to improve knee range of motion and strength.
• Gradual return to daily activity, work, and low-impact exercise.
• Ongoing improvement over several months after surgery.

Is robotic knee replacement right for you?

If knee arthritis is significantly affecting your quality of life and non-surgical treatment is no longer enough, robotic-assisted knee replacement may be an option worth discussing. A detailed consultation, examination, and imaging review can help determine whether you are suitable for knee replacement and whether robotic assistance is appropriate for your condition. The goal is to provide a well-planned, precise, and personalised approach to knee replacement surgery.