By Dr Daniel Meyerkort – Perth Orthopaedic & Sports Medicine
Advancement in knee replacement technology has allowed for vast improvements in surgery since knee replacement surgery became common in the 1970’s. Key advancements in modern knee replacement will be discussed in this article and fall into the following broad categories.
Robotic Assisted Knee Replacement
Virtual Assisted (VR assisted) Gap Balancing
Medial Pivot Total Knee – Advancement in Implant Design
Kinematic Total Knee Replacement
Prehabilitation – The importance of getting fit and strong before surgery
Robotic Assisted Knee Replacement
Robotic assisted knee replacement is offered at Perth Orthopaedic & Sports Medicine Centre and is talked about in depth on this website. Robotic assistance allows for increased accuracy when performing the bony cuts. This allows for precise implantation of your prosthesis, low levels of soft tissue damage and rapid recovery post surgery.
Virtual Assisted (VR assisted) Gap Balancing
Virtual assisted gap balancing is often combined with Robotic technology, but can also be used with standard computer navigation. Virtual gap balancing allows the computer to sense the tension of your knee and to plan how the knee may move and feel before any bony cuts are made. This allows for rapid surgery, low levels of soft tissue damage and implantation of the prosthesis to better match your natural knee.
Medial Pivot Total Knee – Advancement in Implant Design
The medial pivot knee has been designed to mimic the natural knee, being more like a ball and socket on the inner aspect of the knee and flatter on the outer lateral aspect of the knee. This allows for stability within the knee and still allowing a good deal of motion to mimic the movement of the natural knee. The ROSA Surgical Robot is utilised with a medial pivot type design (The PERSONA medially stabilised prosthesis).
Kinematic Total Knee Replacement
Traditional knee replacement aimed to implant the new knee perfectly straight (at 90 degrees to the axis of weight bearing). We know that the normal knee has slight angulations in the joint surface and recent research has focused on mimicking these slight angles ‘kinematic knee replacement’. This has shown to be safe from an implant durability point of view and has also been associated with excellent clinical outcomes.
Prehab – The benefits of getting fitter before surgery
Lastly, the benefits of getting fit and strong with your physiotherapist should not be forgotten. Although not a new technology, the concept of Physiotherapy before surgery is relatively new. Physiotherapists are able to teach you to strengthen your knee (even when it is painful before surgery). This has been shown to decrease pain, provide a faster rehabilitation and provide a better clinical outcome after surgery.