First robot assisted total knee replacement carried out in the UK

April 2018

In the UK, knee replacement operations are increasingly common, carried out on a majority of patients between the ages of 60 and 80. Surgery is carried out when the knee joint has been worn or damaged by trauma, wear or disease to the point where patients experience pain even while inactive. Osteoarthritis is a leading cause of knee joint degeneration, as are rheumatoid arthritis, gout and injury.

Knee replacement surgeries are not without risk, and can have long recovery times especially for patients who are more elderly and find it difficult to exercise in order to build up strength. However over recent years, innovations in this field are driving surgeries to be more precise, less invasive and with increased recovery success rates.

In an exciting European first, a robotics-assisted total knee replacement surgery has been carried out at Spire Bushey Hospital near Watford in the UK. Spire Bushey Hospital is the private hospital of choice for knee replacements in London and the surrounding areas, with more knee ops carried out between 2016-2017 than in any other London hospital.

What is the Navio Surgical System?

Developed by global medical tech company Smith & Nephew, the Navio Surgical System combines real-time imaging with hand-held robotics to assist in total or partial knee replacement procedures. The hand-held device is attached to a small portable cart which can be easily manoeuvered between operating rooms or facilities, giving flexibility and efficiency to medical staff. Direct surface mapping is used to create a 3D image of the joint, allowing surgeons to map out patient-specific operations without the need for a CT scan prior to surgery. This imaging also allows the surgeon to accurately identify and select the bone areas to be removed by the robotic hand-held device.

Why are these innovations important?

Smith & Nephew observe that despite the relative success of many knee replacements, around 10-30% of patients remain dissatisfied with their results. This can be due to post-operative pain, delayed recovery or readmission to hospital after their surgery. Readmission is also costly for hospitals, and across the world many establishments are financially penalised if they don’t make targets for readmission reduction.

The precision and flexibility offered by the Navio Surgical System aids surgeons in component precision, ligament balancing and preparing the bone for implantation, all factors that drive implant survivorship. The 3D imaging component allows both surgeons and patients to benefit from patient-specific treatment options without the potential for delay that accompanies other robotics-assisted technologies.

Massimiliano Colella, President Europe and Canada, Smith & Nephew, says: “We are proud to support Spire Bushey in being the first hospital in Europe to bring patients the benefits of a robotic-assisted total knee procedure using the NAVIO Surgical System. It is an important innovation as 80% of all knee replacement surgeries globally are total knees, and it is exciting that Spire’s patients can now benefit from the improvements in accuracy that robotics is designed to deliver.”


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