Hip and knee replacement procedures have become routine in the UK, with over 160,000 operations performed every year, according to the National Joint Registry. Improvements in surgical technique and aftercare have increased the chances of success and patients now experience a much more rapid recovery.

Technology innovations in the development of prostheses have also increased implant durability and patients can now expect their replacement hip and knee joints to last many decades.

The history of hip replacement and knee replacement surgery

In the 1960s, Sir John Charnley performed the first successful hip replacement operation to relieve the symptoms of osteoarthritis. The femoral head of the hip joint was removed and replaced with a socket and ball implant composed of polythene and steel and anchored with acrylic cement.

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Hip and knee replacement surgeries are responsible for improving the quality of life of tens of thousands of people in the UK every year.  Over 200,000 hip and knee replacements are carried out in the UK every year, with this number set to grow significantly over the next few years.

Although hip and knee replacement remains major surgery, the knowledge and technical skills that surgical teams have developed since these procedures were first performed, means that both are considered relatively low-risk operations, generally recording very positive satisfaction rate for patients.

Very high satisfaction rates are widely recorded following hip replacements.  Knee replacements seem to be less successful, with authors reporting a degree of disappointment (for a wide variety of reasons) in over 10% of cases. There is a continual strive to keep learning and developing the techniques and tools that ensure the optimal patient outcome.  Accurate component positioning can be surprisingly difficult to achieve with conventional techniques, especially with knee replacements; we think that improving this will have a positive effect on the result.

The relatively recent development of robotic-assisted hip and knee replacement aims to improve the accuracy of the surgery; both of which are offered by London hip and knee replacement surgeon Mr Simon Bridle. Robotic-assisted joint replacement surgery is a pioneering method which allows the surgeon greater ability to tailor the operation to the patient’s individual needs, by accurately planning and executing the surgery. It is not taking skills away from surgeons, more it is enabling them greater scope to deliver more effective patient care.

How does robotic-assisted joint replacement surgery work?

The first step with this technique is to create a 3D computer model of the patient’s knee or hip. The model is then used to plan the most suitable approach to surgery and to effectively troubleshoot the different variables that the surgeon may come up against while performing the operation.

The next stage is the operation itself, and the role of the robotic arm is as follows. Equipped with programming based on the findings from the 3D model.  Essentially the surgeon uses the robot to accurately guide the execution of the surgery.

Data supporting the use of this robotic tool yields positive findings. Clinical studies undertaken recently have commended the MAKO Total Knee Robotic-Arm Assisted Surgery. The following benefits are seen when operations performed manually have been directly compared with those performed with the assistance of a Mako Total Knee Robotic-Arm:

  • Less pain/discomfort following the operation
  • Less need for opiate analgesics (strong pain relief such as morphine)
  • Less reliance upon physiotherapy during the recovery period
  • Shorter stay in hospital
  • Less instances of patients being readmitted to hospital
  • Improved mobility in the knee joint
  • Less soft tissue damage

The studies that have afforded us this data were both designed to “determine differences in early postoperative recovery and time to hospital discharge between patients undergoing conventional jig-based TKA versus robotic-arm assisted TKA (total knee arthroplasty).” Analysts looked specifically at data from patients during the first 24 hours following their surgery. Very encouragingly, data also shows that the robotic arm technique delivers improved accuracy of how the knee implant is inserted into the patient’s joint.

Similarly with robotic assisted hip replacements, there are a number of benefits compared to conventional techniques

  • More accurate positioning of the acetabular component
  • More accurate restoration of the correct leg length
  • Less risk of instability
  • Better function
  • Improved component position leading to lower wear rate and less risk of the joint wearing out in later life

To find out more about the benefits of robotic-assisted knee or hip replacement surgery, call 020 8947 9524 to arrange a consultation with Mr Simon Bridle.

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