Dr Chew Tec Hock Jeffrey
Patients with an early onset of knee osteoarthritis (wear and tear in knee joints) used to be caught in a dilemma. Since a total knee replacement was too severe for early to mid-stage knee osteoarthritis, patients delayed treatment until the pain worsened.
Dr Jeffrey Chew, orthopaedic surgeon at Mount Elizabeth Hospitals, explains how technological advances provide alternatives to treat knee damage according to its severity.
The knee consists of 3 compartments – the medial (inner), lateral (outer) and patellofemoral (between kneecap and thigh bone) regions. If 2 or more compartments of the knee are affected, doctors usually advise a total knee replacement. If only 1 compartment is affected, a partial knee replacement may be appropriate.
According to Dr Chew, surgeons had to perform a partial knee replacement manually in the past, making precise implant placement difficult. However, technological advances, such as the aid of a robotic arm, have increased the precision and viability of a partial knee replacement procedure. This type of surgery is known as robotic partial knee replacement surgery.
Robotic surgery, or robot-assisted surgery, is a type of minimally invasive surgery, where the surgeon uses a specially-designed computer console to control surgical instruments on thin robotic arms.
Robotic partial knee replacement surgery is a robot-assisted minimally invasive surgery that replaces the damaged surface of knee joints with implants. It is designed to relieve pain in the knee caused by the wear and tear of joint cartilage, a condition known as osteoarthritis.
During robotic partial knee replacement surgery, the computerised tomography (CT) scan of the patient's knee is first fed into the robotic system. After the coordinates of the knee implants are mapped out, the robotic system then guides the surgeon visually and aurally in resurfacing the knee and positioning the knee implants.
Preservation of healthy bone and tissue – By targeting and treating only the damaged part of the knee, the surgeon can remove the diseased bone while preserving the healthy bone and tissue surrounding it, minimising trauma and reducing recovery time.
Minimal scarring – Robotic partial knee replacement surgery can often be performed through small incisions of about 4 – 6 inches over your knee, leaving minimal scarring.
A more natural feeling knee after surgery – The preservation of the natural healthy bone and ligaments along with more precise positioning of the implants may result in a more natural feeling knee.
Long implant life – Implant life ranges from 15 – 20 years, which is comparable to the lifespan of a total knee replacement.
Shorter recovery time – Recovery time is reduced due to treatment of only the necessary area. According to Dr Chew, patients are on crutches for a few days to 2 weeks post-operation. After approximately 6 weeks, patients may be able to resume daily activities such as running, swimming and playing football. The knee also feels natural during full flexion (bending) and extension.
This treatment is more suitable for patients with early to mid-stage osteoarthritis of the knee than for those with severely damaged knees. Patients usually undergo the treatment when they find that knee pain prevents them from engaging in activities that they used to enjoy.
If knee pain is giving you pain and difficulty in your normal, everyday activities, talk to your doctor about your suitability for robotic partial knee replacement surgery. Your doctor must complete a thorough medical examination of your knee before determining if robotic partial knee replacement surgery is suitable for you.