Knee Replacement Surgery

Knee pain is a common problem among adults. It may be due to an injury, joint problems or osteoarthritis.

The knee is the largest joint in the body. It is commonly known as the “hinge” joint because it allows the knee to flex and extend, similar to the hinge on a door. The knee can also rotate and glide.

The knee joint is composed of three bony parts:

• Tibia (shin bone)
• Femur (thigh bone)
• Patella (kneecap)

Each bone is covered with a layer of cartilage that cushions, protects and keeps the bones from rubbing together.

Ligaments (bands of tissues) connect the femur and tibia, while muscles and tendons stabilize the knee and enable it to move. The patella helps protect the knee joint and anchors the tendons while allowing movement.

If the cartilage becomes damaged, your bones rub together causing friction, pain and, eventually, deterioration of the bone surfaces. Your doctor may try medications or even minor surgery to treat the problem. When treatment does not help, your doctor may suggest partial or total knee replacement.

The most common reasons to have a knee joint replaced are to relieve severe arthritis pain from conditions such as osteoarthritis or rheumatoid arthritis, or from a traumatic injury.

Your doctor may recommend partial or total knee joint replacement if you experience the following signs:

• Daily pain
• Pain severe enough to restrict work, recreation and ordinary activities of daily living
• Significant stiffness in the knee
• Significant instability (constant giving way) of the knee
• Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee
• Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis
• Failure of non-surgical treatment

During knee replacement surgery, damaged cartilage and bone are removed from the knee joint. Man-made (artificial) pieces, called prostheses, are then placed in the knee. These pieces may be placed in up to three surfaces in the knee joint:

• Lower end of the thigh bone (femur): The replacement part is usually made of metal.
• Upper end of the shin bone (tibia): The replacement part is usually made from metal and a strong plastic.
• Back side of your kneecap (patella): The replacement part is usually made from a strong plastic.

In a traditional or full knee replacement, the damaged bone and cartilage of the knee is resurfaced or replaced with metal and plastic components. In a partial knee replacement, only a portion of the knee is replaced. Partial knee replacements are sometimes referred to as unicompartmental knee replacements. This kind of minimally invasive procedure is an alternative option for individuals whose damage to the knee is limited to just a single area of the knee.

When is a partial knee replacement used?

There are three compartments of the knee: the inside (medial), outside (lateral), and front (anterior) compartment of the knee. When the cartilage in one part of the knee becomes damaged and the other parts of the knee have normal cartilage, you may be a candidate for a partial knee replacement.

There are 45,000 partial knee replacements performed each year in the United States. The Henry Ford joint replacement surgeons are skilled at determining when a patient is a candidate for partial knee replacement and are experienced in performing partial knee replacement surgery.

Benefits of a partial knee replacement

Compared to traditional knee replacement, the benefits of this minimally invasive procedure are:

• Smaller incision and scar
• Decreased pain
• Quicker recovery
• Greater range of motion (when compared to standard total knee replacements)

At Henry Ford, our joint replacement team strives to provide the highest quality care for our patients. Through our drive to continually provide better patient outcomes we regularly conduct research on the latest technology available, like robotic-assisted full and partial knee replacement.

Why choose a robotic-assisted knee replacement?

Your surgeon may choose to perform a robotic-assisted knee replacement for your surgery, as an alternative to the conventional knee replacement procedure. Think of it as a more sophisticated tool to perform a given procedure utilizing the same implants. In this procedure, your specially trained surgeon still performs the entire surgery from start to finish. The surgeon has more detailed knowledge of the anatomy of your knee and is able to customize the knee replacement to you.

How it works

Prior to a robotic-assisted knee replacement, your surgeon will obtain specialized X-Ray views or a CT scan to create a virtual 3D model of your knee. With that model as a guide, your surgeon will then use the robotic arm to customize the location of the components for your knee’s anatomy. With this 3D model, your surgeon is able to start planning your knee replacement before you enter the operating room so your knee is customized to your anatomy. Your surgeon will use the robotic arm to help guide removal of the damaged portions of the femur and tibia for optimal placement of the implants.

What are the advantages for you?

• Additional level of precision with the additional data points and 3D model
• Can be less invasive than traditional knee replacement surgery
• Alleviate arthritic pain
• Improved implant position compared to conventional instrumentation
• Improve ligament balance compared to conventional instrumentation
• After a robotic-assisted knee replacement, you will be walking within hours of surgery. Many patients feel comfortable going home the same day.

Robotic-assisted technology we offer

At Henry Ford, we offer robotic-assisted knee replacement technology, through both the ROSA and MAKO robots. Both provide patients with a knee replacement customized to their individual anatomy and allow you to be at the forefront of technological advancement. For more information, please talk to your surgeon about the best procedure to meet your needs and outcome goals.

MAKO is a robotic arm-assisted technology that will help your surgeon develop a personalized surgical plan based on your unique anatomy.

A partial knee replacement works by selectively targeting the part of your knee that is damaged, your surgeon can replace the diseased part of your knee while helping to spare the healthy bone and ligaments surrounding it.

How it works

Mako SmartRobotics™ is an innovative solution for many suffering from painful arthritis of the knee. Mako uses a 3D CT-based planning software so your surgeon can know more about your anatomy to create a personalized joint replacement surgical plan.

By guiding your doctor during surgery, Mako’s AccuStop™ technology allows your surgeon to cut less by cutting precisely what’s planned to help protect your healthy bone.

What are the advantages for me?

• Precise implant positioning may result in a more natural feeling knee following surgery
• More information available to your surgeon can allow for better reproduction of your normal anatomy

Robotic Surgical Assistant (ROSA) is a tool designed to help your specially trained Henry Ford surgeon tailor the placement of your knee implant to you. ROSA offers a more precise implant placement and improved ligament balance during knee replacement. Getting a precise knee implant fit and joint balance is important to your comfort and may improve your overall outcome and longevity of the knee replacement.

How it works

Our joint replacement surgeons have been specially trained to use the ROSA Knee. The robot is fully operated by your surgeon who works alongside the robot in the operating room the entire time and will be making all the decisions throughout your surgery.

ROSA Knee provides data to create a 3D model of your knee. This enables your surgeon to plan and customize your surgery before entering the operating room.

During your procedure, ROSA Knee utilizes a camera and optical trackers attached to your leg to know exactly where your knee is in space. Think of it like a very detailed global positioning system (GPS) that you might use in your car. If your leg moves even a fraction of an inch, the robot can tell and adjusts accordingly. This information, combined with your surgeon’s skill, helps them know how to position your implant and provide the most balanced joint.

ROSA’s robotic arm assists the surgeon in preparing the bone and confirms the placement of the knee replacement implant.

Your joint replacement surgeon performs the surgery from start to finish with the assistance of the robot. By using this data to make more informed decisions, your surgeon can plan for and carry out a more personalized approach.

What are the advantages for me?

• Added level of precision with additional data points and 3D model
• Can be less invasive than traditional knee replacement surgery
• Alleviate arthritic pain
• Improved implant position compared to conventional instrumentation
• Better ligament balance compared to conventional instrumentation
• Can be less invasive than traditional total knee replacement surgery