Robotic-Assisted Partial Knee Replacement at Apex Hospitals, Jaipur

Robotic-Assisted Partial Knee Replacement

Robotic-assisted partial knee replacement, also called unicompartmental knee replacement (UKR), is a surgical procedure in which only the damaged compartment of the knee is removed and replaced with an implant, while the healthy bone, cartilage, and cruciate ligaments are preserved. The CORI Surgical System by Smith+Nephew guides the surgeon throughout the procedure with advanced computer assistance and a robotics-assisted handpiece.

Partial knee replacement is a potential alternative to total knee replacement for patients with early to mid-stage osteoarthritis that is generally limited to one compartment of the knee. Because it removes and replaces only the damaged portion of the knee, sparing the cruciate ligaments vital to knee stability, it offers several advantages over total knee replacement for suitable patients:

• 1.Less pain following surgery
• 2.A more natural feeling knee after recovery
• 3.Smaller incisions compared to total knee replacement
• 4.Quicker rehabilitation and faster return to activity

Partial knee replacement with traditional techniques vs. robotic assistance

In traditional partial knee replacement, cutting blocks or guides are placed on the thigh bone (femur) and shin bone (tibia) to help direct a surgical saw in removing the diseased bone and cartilage. This method has been considered technically challenging, as accurately placing these blocks can be difficult and relies heavily on the surgeon's manual skill and experience.

In recent years, robotic assistance has been developed to provide a higher level of accuracy and precision in partial knee replacement. With the CORI system, the surgeon is guided by a real-time 3D map of your knee created during surgery, allowing implant placement and joint balance to be planned and executed with significantly greater precision than traditional techniques allow.

CORI does not perform the surgery. It assists the surgeon by providing an advanced computer program that relays precise information about your knee to a robotics-assisted handpiece used during the procedure, enforcing the surgeon-defined plan at every step.

Why might I need a Robotic-Assisted Partial Knee Replacement?

Partial knee replacement is considered when osteoarthritis or damage is confined to one compartment of the knee and conservative treatments have not provided adequate relief. Surgery may be performed for the following reasons:

• 1.Relieve pain in the affected knee compartment
• 2.Improve joint stability and alignment
• 3.Correct bone deformity limited to one compartment
• 4.Maximise quality of life and daily function
• 5.Optimise activities of daily living with a faster recovery than total knee replacement

The orthopaedic surgeon at Apex will evaluate your condition through physical examination, X-rays, and a detailed discussion of your symptoms to determine whether partial or total knee replacement is the more appropriate option for you.

What are the risks of Robotic-Assisted Partial Knee Replacement?

As with any surgical procedure, there are risks involved with partial knee replacement surgery. Every patient's case is unique. You should consult with your surgeon on the specific complications you may encounter. Complications may include, but are not limited to:

• 1.Blood clots: Your surgeon may prescribe medication to help prevent blood clots following surgery.
• 2.Infection: Antibiotics may be given before the surgery and continued afterward to help prevent infection.
• 3.Injury to nerves or vessels: While rare, nerve and blood vessel damage may occur during the procedure.
• 4.Other risks: Individual patient risks should be discussed with your surgeon.

How do I prepare for Robotic-Assisted Partial Knee Replacement?

There are several activities you should plan for once you decide to have surgery. Your orthopaedic team at Apex Hospitals will guide you through each of these steps.

• Initial surgical consultation: Preoperative X-rays, complete past medical history, complete past surgical history, complete list of all medications and allergies (prescription, over-the-counter, vitamin supplements).
• Complete physical examination: Your doctor may determine if you are in the best possible condition to undergo surgery.
• Blood donation: A transfusion may be necessary after surgery, so you may wish to donate blood prior to the procedure.
• Physiotherapy: Instruction in an exercise program to begin prior to surgery and an overview of the rehabilitation process will better prepare you for post-operative care.
• Preparation for the hospital: You may want to bring, clothing (underwear, socks, t-shirts, exercise shorts for rehabilitation); footwear (walking or tennis shoes for rehab, slippers for the hospital room); walking aids (walker, cane, wheelchair or crutches if used prior to surgery); and your insurance information.

Preparation before surgery: Follow your surgeon's instructions for the evening before surgery. You may be advised not to eat or drink after midnight. Shower with a five-minute scrub of the surgical area using special soap as advised. Prepare your belongings in advance.

Preparation for after surgery: Move items and furniture in your home so they are easier to access while your mobility is limited. Remove clutter and obstacles that could be tripping hazards. Prepare meals ahead of time and arrange for visitors or help with everyday chores to make your recovery smoother.

What happens during the procedure?

Robotic-assisted partial knee replacement at Apex Hospitals is performed under spinal or general anaesthesia, which will be discussed and determined prior to surgery with your surgeon and anaesthetist.

1. The surgeon typically makes a 10–15cm incision along the front of the knee, just to the side of the knee cap, to access the damaged area and inspect the knee.
2. Special trackers are secured to both the thigh bone (femur) and shin bone (tibia) with four, 3.2mm pins placed through small incisions in the skin. These trackers are crucial to the precision of the system as they provide a constant reference point for the robot as the surgeon collects your anatomical data and prepares the joint surfaces.
3. The anatomical data collected is used to generate a 3-dimensional virtual model of your knee, which the surgeon uses to precisely plan your partial knee replacement — including proper implant placement and knee balance — achieved virtually before any bone is removed.
4. When the surgical plan is set, the CORI robotics-assisted handpiece is used by the surgeon to accurately resurface the joint, guiding the instrument over the damaged femoral and tibial bone surfaces.
5. After the damaged bone and cartilage have been removed and the implants are in place, the incision is thoroughly cleaned and closed to complete the procedure.

With the robotic assistance system, proper implant placement and knee balance, important to a successful surgery, are first achieved virtually before being executed with precision. The surgeon remains in complete control throughout.

What happens after the procedure?

Immediately after surgery you will be transferred to the recovery room. In addition to the incision along your knee, there will be two small incisions on both your thigh and lower leg where the tracker pins were placed. Ice packs and analgesics may be used to reduce swelling and manage pain.

Each patient's postoperative care will vary, as severity of injury and surgical complexity can differ. Early movement of your operative knee with assistance is encouraged. Patients are typically allowed to walk with the assistance of a cane, crutches, or walker shortly after surgery. A physiotherapist will prescribe exercises to help restore knee strength and function and increase range of motion. It is common for your knee to experience swelling, stiffness, and tightness during this time.

Rehabilitation following Robotic-Assisted Partial Knee Replacement

The success of your surgery will largely depend on how well you follow your surgeon's instructions in the first few weeks following surgery. How quickly you recover depends on factors such as knee pain, flexibility, strength, and balance. Follow-up visits will likely be scheduled to check on your condition and progress as you recover.

In order for you to meet the goals of knee replacement surgery, you must take ownership of the rehabilitation process and work diligently on your own as well as with your physiotherapist. The rehabilitation process can be quite painful at times. However, if you commit to following your program and overcoming the challenges in rehab, you will succeed in meeting the goals you set when deciding on surgery

Speak to our team about Robotic-Assisted Partial Knee Replacement

We encourage you to speak with our orthopaedic team if you have questions or concerns about partial knee replacement. Our specialists can evaluate your condition, help you understand whether partial or total knee replacement is appropriate for you, and explain how robotic assistance improves outcomes. Our team at Apex Hospitals is here to support you through every stage of the process.

Take the first step towards pain-free movement. Book a consultation with our orthopaedic specialists at Apex Hospitals today.

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