Robotic Knee Replacement

Arthritis is a condition in which swelling and tenderness is observed in one or more joints. The commonly found symptoms are joint pain, stiffness, decreased range of motion which gradually worsens with the age. The most common types of arthritis are osteoarthritis and rheumatoid arthritis.

The management of arthritis is mainly aimed at controlling the pain, minimizing joint damage, and improving or maintaining function and quality of life. A range of medications and lifestyle strategies can help achieve this and protect joints from further damage. The level of management depends upon the severity of the condition which ranges from anti-inflammatory medications to Total Joint Replacement Surgeries.

• It is the most common orthopaedic procedure, performed to facilitate pain-free movement, by replacing damaged and diseased knee joints with prosthetic components.
• The procedure is recommended for patients with severe joint damage, when the joint is completely worn out, accompanied by progressive pain and loss of mobility.
• The goal of knee replacement is to relieve pain, improve mobility, and restore function.
• The success of knee replacement depends on many factors, which include leg alignment, position and fit of the implant.
• Modern implants, available nowadays, can last up to 30 years

Jupiter Hospital is equipped with the second generation most advanced robotic knee replacement system CORI

• It is a new and innovative technique that involves the use of 3D imaging guidance and robotic arms to carry out the knee replacement procedure. The arms are controlled by our experts with the help of a special console.
• The procedure works by reconstructing virtual patient anatomy.
• The procedure offers faster rehabilitation and optimum range of motion, without much compromise on the demands of a routine life
• Robotic-assisted knee surgery comes with many benefits, which include detailed surgical planning, added precision, smaller incisions, greater ligament sparing options, accurate fit of implant, better positioning and excellent soft-tissue balancing
• Robotic Precession is complemented by the excellence of our surgeons, to give the patient maximum benefit of the operation.

Success of the joint replacement surgery depends on accuracy of the implant, alignment of the joint after surgery and how the ligaments are balanced while doing the surgery.

The Robot tells the patient specific anatomy, its ligament structure and inherent balance of the joint. This helps to choose the accurate size of the implant, customized according to the exact anatomy of the joint which ultimately increases the success rate of the surgery.

It is just like using the Google map. The google map tells us about the distance between the two points and the correct route to reach the required point. If you take the different route it again navigates to the correct one. In the same way, the robotic arm gives the accurate pathway to reach the desired point. Not only this but the arm would stop the moment if it senses the deviation, even of a millimeter, from the desired pathway.

Before surgery, a CT scan is used to create a 3D model of the patient’s knee. This allows surgeons to more accurately place the implant. During the operation, the robotic arm uses data from the 3D model to create a predefined space for the surgeon to work in, preventing them from accidentally damaging the surrounding tissue.

In this way the robotic surgery helps to achieve the required outcome in terms of alignment and balance. Hence, the surgery can be done in most accurate and most predictable manner.

1. Much lesser pain
Decreases the inflammation by foreign bodies thereby decreasing the pain and so the need for pain killers. Hence the patient is less drugged and feels apparently fresh.

2. Preserves the maximum native bone
The incision is made using the probe in Robotic arm-assisted surgery. There is no need of using the saw or the blade which minimizes the blood loss and also reduces disturbance to the native bone.

3. Very fast recovery
In Robotic-Assisted surgeries smaller incisions are made along with greater surgical precision. This leads to less bone and tissue disturbance which ultimately speeds up the body’s natural healing process.

4. More natural feeling after surgery
On patient’s perspective the success of the surgery will be measured on the basis of joint awareness. Ideally, the patient should forget about his joint replacement surgery as he goes about his day to day life. But in some cases, simple activities like climbing down the stairs or kneeling can trigger the joint awareness in form of stiffness, numbness or sometimes pain. Using the Robotic technique, the implant is chosen as per the patient specific anatomy which improves the accuracy. As per experts, more the accuracy, less will be the joint awareness to the patient.

5. No extra radiation required
The Robotic arm used in the surgery comes with the enhanced robotic software solution that delivers the image-free, smart mapping. Real-time characterization of bone and cartilage through landmark collection and point mapping, without preoperative imaging. The requirement to undergo frequent radiations like CT scans or X-rays before and after the surgery reduces significantly by this technique. This gives relief to the patient providing the hustle free procedure.

6. Unicondylar Knee Replacement
Traditionally unicondylar knee replacements were not looked upon very favorably because the chances of failure made the patient to undergo total knee replacement or redo joint replacement. With the help of this technology, the success and predictability of the unicondylar knee replacement has increased. Therefore, more and more surgeons are confident in providing this option to their patients.

Jupiter Hospital is well equipped with the second generation most advanced robotic knee replacement system, CORI. It is the most advanced and efficient handheld robotic solution backed by Real Intelligence, designed to change the face of orthopedics.

Intelligent platform supports robotics, software, smart tools and data.

Enhanced robotic software solution that delivers:

• Image-free, smart mapping (No CT/MRI required)
• Real-time characterization of bone and cartilage through landmark collection and point mapping, without preoperative imaging.
• Real-time planning and gap assessment
• Provides a 3D model of patient anatomy
• Optimized* alignment and balance

Surgeon-controlled, handheld intelligence for a modern robotic approach

• Enhanced robotic knee workflow that saves time in the O.R.
• Portable robotics designed to offer the smallest footprint in orthopedics

Patient-specific planning:
Visualize cuts and gap balancing prior to bone preparation, to help eliminate extensive ligament releases. Customize the plan for each patient using mechanical alignment and ligament data.

Robotics-assisted bone preparation:
Handheld milling technique uses two control modes, exposure and speed control, which automatically adjust to execute patient-specific plans.

Redesigned robotic handpiece with improved ergonomics

• New bur designs delivering 2X cutting volumes
• 29% faster resection
• Cut more in less time.

• 458% faster refresh rate*1
• Designed specifically for robotic surgery

• Size, orient and align components virtually on a 3D model
• Confirm implant placement relative to the articulating surface
• Adjust implant placement to balance soft-tissue throughout the full range-of-motion (UKR only)

Pre-evaluations
When the patient visits the Orthopaedic surgeon in the OPD with the knee pain, swelling and stiffness in joint, the consultant understands the severity of the condition, they may recommend less invasive treatment methods first, such as:

• Anti-inflammatory medications
• Weight loss through diet and exercise
• Cortisone shots
• Physical therapy
• Knee braces

But if the symptoms are not relieved with conservative treatment, joint replacement surgery will help. The doctor will ask to undergo the diagnostic tests like X-ray, CT scan before suggesting the replacement surgery.

Surgical Procedure and The Hospital Stay
Once the surgery is planned, the patient has to undergo other invastigations like laboratory tests. The surgery is performed by the joint replacement surgeon who is well trained with the technology, and also having deep core knowlegde and experience in the subject. The patient will have to go for hospital stay for 3 to 4 days or as suggested by the doctor.

Post-Operative care
The rehabilitation process is started right on the same day or on the next day of the surgery. The patient is asked to walk with the support making small steps. Physical exercises are advised by the physiotherapists to achieve near normal gait pattern and maximum range of motion. The patient is asked to continue with the exercises even after discharge and follow ups are taken periodically.