Performed by – Khalid Al-Hourani, Alastair Davidson, Richard Hargrove Azal Jalgaonkar, Reza Mansouri, Zuhair Nawaz, Andrew Perry, James Singleton, Seb Sturridge

Total knee replacement
Total knee replacement (TKR) is a surgical procedure in which injured or damaged sections of the knee joint are replaced with artificial parts. It is commonly performed for arthritis of the knee where the joint has become stiff and painful. Initially, arthritis can be treated with painkillers, anti-inflammatories, physiotherapy and in the earlier stages, arthroscopy (keyhole surgery), but as the knee progressively wears, joint replacement surgery may be required to relieve the pain and improve mobility.

What happens in surgery?
The surgery involves an incision over the front of the knee and through the quadriceps muscle. The surface of the joint is removed including a small thickness of the damaged bone ends of the knee – usually about a centimetre of bone is removed during the operation. The metal of the knee replacement fits on the cut ends of the bone and is fixed to the bone with cement, with plastic between. The operation takes about to an hour and a half.

Customised knee replacement
There are many different types of knee replacement all of which the surgeons at Joint Reaction have experience in performing. Your surgeon will assess your knee and discuss the best option for you. One option, which is useful in some cases, utilises pre-operative scans to build customised cutting blocks to guide optimal knee replacement. This is not necessary in all cases but has some advantages.

The component parts of the TKR
The Total Knee Replacement comes in three parts. The femoral component is made of metal and is highly polished. The tibial component is made of metal with a curved plastic tray attached to its upper surface. This forms the new joint with the metal femoral component. The back of the patella is covered with a plastic button, which sits in a shallow groove on the front of the metal femoral component.

After a total knee replacement
With the aid of a physiotherapist you will get out of bed and begin to exercise your new knee replacement. With perseverance, you should be able to climb stairs by day 3 and usually go home between day 3 and 5 depending on the speed of your recovery. Post-operative Physiotherapy, range of movement stretches and functional exercises are all very important to gain full function and range of movement of your TKR to get the best result of your TKR. You will need to continue attending physiotherapy as an outpatient. This can be done closer to your home with one of our recommended group of physiotherapists. For most people it will take around six weeks to be walking reasonably with only one stick and get back to driving a manual car, but three months to fully recover. It is important to remember that an artificial knee is not a normal knee. You should be able to carry out all normal activities of daily living. However the range of movement may not be as good as it was before surgery and you may be too uncomfortable to kneel after your knee replacement, although kneeling will not damage the knee. You should be able to get back to golf, gentle game of tennis, cycling, swimming.

Lifespan of the TKR
The majority of knees last ten to fifteen years with studies suggesting that a Total Knee Replacement in a 70-year-old has around a 94% probability of lasting for 10 years after surgery. If, however, the patient is younger and more active the replacement may not have such a high survival rate, in which case your surgeon will discuss other options with you .Robotic-assisted knee replacement surgery can lead to better outcomes and a faster recovery.

Robotic Assisted Knee Replacement

Robot-assisted, not robotic
The procedure is more accurately described as “robot-assisted” because the robot doesn’t perform the surgery independently. A surgeon guides the robotic arm whilst receiving accurate measurement feedback throughout the operation so implant positioning can be customised individually to the patient’s anatomy.

Enhanced precision
The robotic system’s real-time feedback allows for more precise bone preparation and implant placement, leading to better alignment.

Personalised planning
Robotic data allows 3D modelling of the patient’s knee and soft tissue balance allowing for a personalised surgical plan based on each patient’s unique anatomy.

Benefits

• Better Alignment and Balance: The robotic system helps surgeons achieve optimal alignment and balance of the knee joint.
• Improved Accuracy: Greater accuracy in implant placement and bone preparation.
• Reduced Pain: Some studies suggest that robotic-assisted surgery may lead to less post-operative pain.
• Potential for Faster Recovery: While recovery times can vary, some patients may experience a faster recovery with robotic-assisted surgery.