Robotic knee surgery versus traditional methods

Written by: Mr Ash Gulati
Published: | Updated: 09/11/2021
Edited by: Sarah Sherlock

As technology is advancing more in our everyday lives, it is evolving how procedures are done in operating theatres. One of the more advanced in orthopaedics is robotic-assisted knee surgeries. Experienced consultant trauma and orthopaedic surgeon Mr Ash Gulati explains the newer procedure and how it compares to the traditional method.


mako robotic knee surgery


What is robotic knee surgery vs traditional knee surgery?

In a traditional non-robotic knee replacement, including computer navigation surgery, the surgeon makes bony cuts using various guides based upon the information obtained from static investigations such as X-rays, CTs, and MRIs performed before the surgery.


On the other hand, with the robotic knee surgery, in addition to the static imaging data collected before surgery, dynamic assessments are made at the time of surgery while making bone cuts so that the procedure can be customised to each patient. This allows better prediction of soft tissue balance and tensioning of the surrounding ligaments and tendons.



What are the advantages of robotic knee surgery?

Robotic-assisted knee replacements are advancement over previous generation of knee replacements. Pre-op 3D imaging and planning is used to enhance the accuracy and permits to implant knee components tailor-made based on a patient’s individual anatomy.


In addition to allowing superior precision, robotic surgery is less invasive than conventional knee replacement with smaller incisions, and less disturbance to surrounding bone and tissue. Since the knee implant placement is more precise, it results in less friction and wear for the new components and less risks requiring future revision surgery.



How long does the robotic surgery take and how long is the recovery?

The actual surgery will last approximately one hour. Patients are permitted to walk soon after the procedure, and most are back to normal daily activities, such as driving a car, within two weeks. Unlike traditional nonrobotic-assisted approaches, Mako procedures require fewer soft tissue releases. This means there’s less pain and a faster recovery. And, because your surgeon can provide a better joint alignment using Mako technology, it can mean you walk more naturally, sooner.


mako robotic knee surgery
Mako robotic-arm assisted surgery by Stryker.


Is robotic surgery more painful?

Due to advances in pain management techniques during your surgery as well as the Mako procedure itself, patients’ pain is significantly decreased compared to total knee replacements of years past. Since the surgery is less invasive than conventional knee replacement with smaller incisions and less disturbance to surrounding bone and tissue, patients experience less pain and faster healing, enabling them to return to normal activities much sooner.



Am I suitable for robotic knee surgery and will my insurance company cover it?

Robotic-assisted technology can be used for both partial and full knee replacements. Anyone with knee arthritis who hasn’t had a joint replacement before is a good candidate for Mako robotic-assisted surgery. Patients who need a previous joint replacement revised or redone are not suitable. Most insurance providers cover the robotic knee surgery as a standard, but you should double check with your insurance company to learn about your plan.



Are there any cons to robotic knee surgery?

The procedure takes slightly longer to perform than a conventional joint replacement so that all the extra checks and measurements are carried out. So, theoretically, the risk of infection could be slightly higher although this has not been proven in any scientific study so far. As ever, the computer system is only as good as the data it uses and the people who process it. So, it is important that only fully trained personnel are allowed to carry out robotic knee surgery.


The cost of the procedure is also slightly more than a conventional joint replacement because a pre-op CT scan is required to plan the procedure, but most insurance companies cover it as a part of the standard cover.



If you are having knee pain or are seeking to have a knee replacement, you can go to Mr Gulati’s profile and book a consultation.

By Mr Ash Gulati
Orthopaedic surgery

Mr Aashish (Ash) Gulati is a leading consultant trauma and orthopaedic surgeon with more than 15 years of experience. He provides patients with first-class care across Birmingham, Droitiwch Spa and Sutton Coldfiled.

He is highly trained and skilled in treating orthopaedic problems in all age groups, from high-performance elite athletes to elderly patients with arthritis. He is an expert in hip and knee replacements, including partial knee replacementstotal knee replacements as well as custom-made and robotic knee replacements. Patients can also have Mr Gulati's expertise for their knee revision surgery. He is especially interested in partial knee replacement, did extensive research and pursued PhD at the Univesity of Oxford investigating the factors that affect outcomes, after this surgery, and perfecting his surgical techniques.

He has experience in performing minimally invasive surgery for the knee and hip, robotic knee surgery, arthroscopy and ligament reconstruction, amongst other procedures. He is also able to assist patients with sports injuries, from avid sports players to elite athletes, and he provides novel therapies such as dry needling, autologous blood injections, high volume injections and platelet-rich plasma injections. He is one of the few orthopaedic surgeons in whole country, who is trained to perform these injections using an ultrasound machine to improve their accuracy. He ensures that he stays up-to-date with the most innovative techniques, therefore providing patients with the most appropriate and effective treatments.

His basic surgical training in took place in Cambridge, Glasgow and Preston. This training was followed by specialist orthopaedic training on the prestigious Oxford Orthopaedic Training Programme at the world-famous Nuffield Orthopaedic Centre and John Radcliffe Hospital. He pursued hip and knee revision surgery fellowship at Nottingham. He then moved to Toronto, Canada and did a placement at the Sunnybrook Hospital where he concentrated on managing sports injuries and complex trauma. Throughout his career, he has been awarded travelling fellowships at the Endoclinik in Hamburg, Lyon Orthopaedic Centre and at Granggates Clinic in Geneva. 

Having a keen interest in medical research, he has published over five book chapters, 25 original papers in high impact peer-reviewed journals and has contributed to over 50 academic presentations at national and international conferences.

Mr Gulati also devotes his career to the teaching and training of medical students. This involves students from the Universities of Oxford, Birmingham, Nottingham, Bristol, Toronto and Glasgow. He prepares Registrars for the FRCS (Fellowship of the Royal Colleges of Surgeons), Trauma and Orthopaedics examination. He also various academic events and has been a faculty on many educational courses.

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