Robotic-assisted partial knee replacement surgery allows surgeons to be more accurate in positioning implants, enables implants to last longer, and improves patient’s overall feel and function of the knee. The first two decades of the 21st century have seen a proliferation of robotic-assisted surgical technology. Over 50,000 procedures have been reported to be carried out of date in the U.S.
According to Scott M. Desman, M.D., F.A.A.O.S., a board-certified orthopaedic surgeon specializing in joint replacement surgery at South Florida Orthopaedics & Sports Medicine, many patients that need a knee replacement aren’t aware that a partial knee replacement may provide a better outcome and give them a greater chance of success.
“I’ve been doing robotic-assisted partial knee replacements for about ten years,” says Dr. Desman, “and there are certain advantages over total knee replacements by doing a partial knee replacement. Of the patients that require knee replacement surgery, about 20% are eligible to have a partial knee replacement. Many of those patients who are offered total knee replacement don’t even realize that they could be a candidate for a partial knee replacement.”
What is a Partial Knee Replacement?
A partial knee replacement is an alternative to total knee replacement for some patients with osteoarthritis or deterioration of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee.
In the past, partial knee replacement was reserved for older patients who were involved in few activities. Now, partial knee replacement is often preferred in the younger population as their recovery is quicker and often with much less pain.
Many individuals put off a partial knee replacement until pain and loss of function become unbearable. At first, patients may attempt to alleviate their symptoms with conservative treatments and therapies such as lifestyle changes, pain medicine, steroid injections, and strengthening exercises.
Patients who undergo robotic-assisted partial knee replacement typically have fewer complications and future revision surgery is needed less often. Moreover, the procedure is faster and less invasive than conventional knee replacement surgery, so patients feel less postoperative pain, heal faster, and are able to return to their normal activities sooner.
For Dr. Desman, educating patients about the options available to them is a critical step in the process. “The first thing to know is that this technology is available,” he says. “The nice thing about it is that patients recover much sooner and quicker than with a full knee replacement. And because most of the knee remains part of a patient’s native anatomy, a partial knee replacement feels much more natural to them. So they get better results.”
“Knee replacement is used when a part of the knee or the entire knee is worn out,” Dr. Desman continues. “A lot of people think that a knee replacement involves removing the entire knee and replacing it. But the procedure replaces just the surface of the knee. And a better name for a total knee replacement would be total knee resurfacing. That being said, if only one part of the knee is damaged, then only one part of the knee needs to be resurfaced.”
Smaller Implants: Better Results
With a partial knee replacement, a surgeon only replaces the side of the knee that’s damaged instead of the entire knee, conserving healthy bone, tissue, and ligaments. Moreover, the size of the implants for both the ends of the thigh bone (femur) and the shin bone (tibia) are much smaller for a partial knee replacement than for a total knee replacement. The smaller implants used in a partial knee replacement allows the surgeon to make tinier incisions to implant the device.
“More importantly, if the other side of the knee is normal, they don’t need to be replaced,” says Dr. Desman. “This includes not just the bone but the ligaments. So the anterior cruciate ligament and the posterior cruciate ligament remain intact when you do a partial knee replacement. In a total knee replacement, those ligaments are generally removed to make room for the implant.”
Robotic-Assistance Provides Greater Accuracy
“If there’s any way that the knees do not run in a proper manner, we can make adjustments before we make any cuts,” says Dr. Desman. “Then we bring the robot in and make a small incision. The robot has a little handheld cutting device that allows us to cut and remove the bone to allow the implant to fit in the space that’s created.”
“The computer enables us to cut the bone in the exact space where the implant will fit in precisely. It doesn’t go in crooked, too far up, too far down, or too far to one side. And the same is done for the lower bone. The computer allows us to put the implant in so it’s perfectly straight. It’s not crooked in any of the three spheres of motion. We can then move the two implants together on the patient. And we can watch the computer and make sure that everything tracks properly. This allows for a perfect result in terms of the way the implant functions in the patient.”
For more information or to learn if a partial knee replacement might be right for you, please feel free to contact us.