In Robotic Total Knee Replacement procedure, a robot is used to take required surgical bone cuts and also to define soft tissue tension. Considering the superiority of this technology, one can surely expect the best post-surgical outcomes with robot i.e. CUVIS Joint as against manual way of surgery.
Standard robotic knee replacement with CUVIS Joint typically comprises of :
CUVIS Joint robot for knee replacement is based on 4 core values of simplicity, accuracy, flexibility and safety.
Pre-selection of artificial joint and precise insertion of artificial joint
Precise cutting for sub-millimeter accuracy and optimum alignment
Reduction of side effect and reoperation
The procedure for a Total knee Replacement (TKR) has advanced greatly with the development of new materials and the increasing understanding of the knee joint biomechanics. An accurate alignment of the component and soft tissue balancing has been cited as the essential for the success of Total knee Joint Replacement (TKR).
In traditinal knee replacement metal blocks and intramedullary rods are used for bone cutting and as measurment tools. Althought mechanical alignment guides have been designed to improve accuracy,there are several limitations to this and errors are possible
There are limits on improving the alignment accuracy using a conventional total knee replacement. In robotic knee replacement joint axis and bone alignment is defined with help of CT Scan so no intramedullary rods are required. Patient specific 3D bone model is developed with help of CT Scan and bony cuts are taken on this 3D bone model to check accurate positioning of implants.
It is like performing surgery on bone models before performing surgery on patient.This removes all errors which can occur with converntional knee replacment procedure. In robotic surgery bone mapping done with help of sensors and cameras. These sensors and cameras also help in measuring soft tissue tension, this improving gap balancing. As implants are well balanced this leads to longer life of implants and greater movements are possible after total knee replacement.
You will be assisted to sit up about an hour after surgery. You will be encouraged to walk 3-4 hours after surgery. You will be assisted to stand and start walking with walker on same day of surgery. This is all possible with use of true balance technique and local infiltration of anaesthetic agent at time of surgery.
On day two you will be demonstrated exercises which includes knee cap tightening and loosening, ankle and toe movements. Knee range of movements will be started. You must do these exercises 15-20 times every hour. This will help to mobilise your knee.
Knee bending exercises will be increased. During the day you will be walking 3-4 times with walker. Once you gain confidence you will be demonstrated how to walk up a staircase. You will be allowed to do the exercise by yourself. You will be allowed to sit on chair.
You must not keep pillow or towel under the operated knee, this is to prevent flexion deformity of knee. To prevent knee deformity put one or two pillows under the lower 1/3rd of leg so that knee hangs in mid air and there is no pressure over heel area.
Dr. Saurabh Giri is One of the Experienced & Leading Joint Replacement Surgeon and Arthroscopy surgeon Practicing in Pune and PCMC.
He is currently working as Head of Department Robotic Joint Replacement at Deccan Hardikar Hospital & Head of Department Orthopaedic & Robotic Joint Replacement at Accord Hospital. He is also visiting consulting at ONP Prime Hospital & Sahyadri Hospitals. He has vast experience of 14 years and has experience of working at two international hospitals which includes Santo Spirito hospital Italy and Helios Endo Klinic Germany. Dr Saurabh has also worked as a consultant Orthopaedic surgeon at some of India’s big hospitals for Orthopaedic surgeries like Mewar Hospital Udaipur, Shalby Hospital and at Deenanath Mangeshkar Hospital. He has completed MS orthopaedic from a central institute. He was University topper and has received Gold medal for MS Orthopaedic. He has experience of performing more than 6000 surgeries under his belt. He has received prestigious SICOT fellowship in Hip and Knee arthroplasty (Joint Replacement), at Rome Italy.
During this fellowship he has mastered the art of performing Hip arthroplasty using direct anterior approach and using short stem for Hip arthroplasty which are highly advanced techniques.He has also received fellowship in Revision surgery in Hip and knee arthroplasty from Helios Endo Klinik, Hamburg, Germany. He has given many national and international presentations on topics related to Knee Joint Replacement, Knee Arthroscopy and Orthopaedics.His expertise includes knee replacement surgery, hip replacement surgery, knee arthroscopy, pelvis and acetabulum surgery. Dr. Saurabh Giri is known for compassionate care and excellent results which he delivers to his patients.
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When compared to conventional manual Knee replacement surgery, robotic knee replacement has got lot of advantages in terms of better implant positioning, precise surgical bone cuts, no human error, faster recovery and less hospital stay. Considering it's minimally invasive nature, it causes lesser tissue trauma and thus less blood loss and faster recovery.
Advanced robot like CUVIS Joint have best in class safety features and do not cause any additional risk to patients undergoing knee replacement surgeries. With advanced features like Bone Movement Monitoring and Haptic Feedback mechanism, it monitors everything in real time. Thus, it delivers best surgical outcome with maximum safety to the patients.
Even though robotic technology for knee replacement is the most advanced therapy option in today’s scenario, there are different types of robots available in market. Amongst all, CUVIS Joint is the only robot which is autonomous in complete sense. Other options of robot just act as a guiding system for surgeon and thus posses the risk of intra-operative human errors. These systems are called as passive or semi-active, whereas CUVIS Joint is of active nature
Three to Four days For a single TKR.
Any operative procedure will lead to post-operative pain. With use of drugs infiltrated at surgical site during surgical procedure we aim to make post-operative pain minimal. Your pain will be kept under control by team of pain management consultants.
Your progress after going home will be roughly as follows : After going home on the 4th day after surgery you will be advised to walk in the house for 4-5 times a day. The stitches on the operative wound will be removed 14-16 days after surgery . Other activities like swimming , driving a car or a two wheeler and kitchen work are permitted after 4- 6 weeks.
You can take short flight, 4 days post surgery, long Flight can be taken 15 days after surgery.
You should avoid sitting on floor. You may sit cross legged, but on a bed or on a higher level surface.