When you think about osteoarthritis in the knee, what comes to mind? For most people, it’s generalised damage across the whole joint. But actually, it doesn’t always look quite like that.
Arthritis can also affect a specific compartment of the knee. We have three compartments in total – inner (medial), outer (lateral) and front (patellofemoral) – and of those, most people with isolated compartment arthritis tend to be affected on the inner side. For about one in 10, it’s the outer side.
This is one reason why surgeons offer partial knee replacements as well as total replacements. A partial replacement enables us to repair one compartment (a unicompartmental operation), or sometimes two together (bicompartmental).
Some partial replacements, however, can be more challenging to perform than others, partly due to the different tensions and balances involved in those compartments. This is the case with bicompartmentals and outer / lateral unicompartmentals.
So… how does robotic surgery come in?
Robotic surgery uses a computer-powered mechanical arm to guide the surgeon during the operation. Although it sounds rather futuristic, the technology has actually been in use since the 1980s. The Nuffield Wessex introduced its first Stryker Mako robot in 2019, but the Mako itself has performed more than 100,000 operations around the world.
There are two key reasons why a robot-assisted operation is a potential positive for partial knee replacements – especially the more challenging ones.
Planning – the process starts by taking a multi-angle CT scan of your leg and turning it into a 3D virtual model. This is loaded into the computer system, where we can look at it in detail, see the full alignment of the leg, and map out exactly where the implant/s should sit within the knee and where we want to make the cuts. This all happens well before you come into theatre, so we’re able to plan the key elements of the operation in detail beforehand.
Precision – although it sounds as if the robot is performing the op, the human surgeon is actually the one who controls the robotic arm and makes the cuts. But with the computer’s assistance, those cuts are exceptionally precise; the arm is capable of operating within a fraction of a millimetre. This helps us to preserve the maximum amount of healthy bone and tissue in your knee, which in turn can help to reduce post-surgery pain and speed recovery. It also gives us the best possible chance of getting a great fit and alignment for those uni implants, which helps to encourage more natural kinematics (movement) in the new joint.
If a partial knee replacement is something you’re looking into, do consider getting in touch with us to discuss the operation in more detail. We’ll be very happy to talk you through the process, and whether the Mako robotic procedure might be a good option of you. You’ll find lots more information on our website too, including a full guide to the technology in our robotic-surgery section, along with links to research and a partial knee replacement case study with one of our recent patients.
Looking to make an appointment? Call Cheryl on 01962 8261207 or check in direct on the website.