13.06.2019

Robotic knee replacements a first in the North East

Orthopaedic surgeons at Newcastle’s Freeman Hospital are the first in the North East to use robotic surgery in the NHS for knee replacements.

The Newcastle Hospitals is a nationally recognised centre of excellence for leading edge robotic surgery and offers it in seven different clinical specialties - more than any other trust in England.

The latest clinical area to embrace this innovative technology is orthopaedics – specifically in the field of total knee replacement. The new approach involves a MAKO robotic arm, designed to support the surgeon to carry out knee replacements as accurately as possible.  

Margaret Smith - the first patient to have a knee replacement with the MAKO robotic arm

Total knee replacement is one of the most commonly performed surgical procedures in the world, with over 100,000 carried out in the UK alone each year. It is literally life-changing for many people suffering from chronic knee pain, primarily caused by arthritis.

Yet, we know that between 10 and 20% of patients who undergo knee replacements are disappointed with the outcome of their operation, with some needing revision surgery.

Newcastle’s experts, Professor David Deehan and Mr David Weir, have carried out over 2,000 of these operations using the high performing Triathlon implant, using conventional techniques.

They believe the poor experiences reported may be due to the difficulty in positioning the knee implant precisely.

Professor Deehan, consultant orthopaedic surgeon specialising in revision and complex knee disorders at the Freeman Hospital explains: “Proper implant position and balance of the soft tissues during surgery are extremely important factors that can affect the success and longevity of a total knee replacement. Dissatisfaction with the return of function after knee replacement remains a challenge.

“Part of the solution to such is tailoring implant position in the joint to match the patient’s soft tissues. Robotic assisted surgery offers the promise of improving the surgeons’ ability to achieve this.”

Mr Weir who also specialises in complex knee surgery adds: “In Newcastle, we underwent comprehensive training at the Newcastle Surgical Training Centre, and are fully certified to introduce robotic assisted surgery using the MAKO robotic arm.

“This technique ensures the tissues, ligaments and implant are all correctly balanced, enabling full range of knee movement, as smoothly as possible.

“We’re very pleased with the results so far and are looking to offer this option to all our total knee replacement patients in future, initially as part of a randomised trial to help us compare outcomes against the conventional technique.”

Patient Story

Grandmother of two Margaret Smith was the first NHS patient in the North East to have her knee replaced with the use of the MAKO robotic arm.

The 71 year old from Chapel Park in Newcastle has arthritis which affects many of her joints.

Of the operation Margaret says: “I was invited to meet Mr Weir and so I went along with my daughter in law. We watched a video which explained all about how the robotic system worked, and how it helps to make the surgery so precise. I felt very happy and confident to have my operation by Mr Weir.”

Prior to her surgery, Margaret had a CT scan of her leg to capture clear and detailed images of all the bones and joints.  

Anatomical features from the CT scan are used to create a 3D model of the knee to plan the positioning of the implant, and ensure the surgeon can accurately perform the bone cuts during surgery using the robot.

The robotic arm uses the information from the CT scan to ensure the bones are cut at the correct angle and depth, and for the knee implant to be inserted in the optimum position.

Mr Weir says: “It’s really important to emphasise that the robotic arm does not perform the surgery – it is guided by the surgeon.

“We use exactly the same knee replacement implants, which we attach to the bone surface in exactly the same way as during a standard knee replacement procedure.

“The difference is that by using the robotic arm, we know we can position the knee in the optimal place.”

A couple of days after her operation, Margaret was moving around confidently with a little support and was already able to bend her knee to nearly 90 degrees.

Margaret was then reviewed in outpatients eight weeks later and says she is thrilled with how her knee feels. “When I went to visit my friends not long after my operation, they couldn’t believe that I was up and about without using any walking sticks. One even asked me where my wheelchair was!

“I’m so pleased to have had the operation and would recommend it to anyone who needs a knee replacement.”

Mr Weir adds: “I’m very pleased with the outcome of Mrs Smith’s surgery. How her knee looks and is performing just eight weeks later is the best we could have hoped for.”

ENDS

If you would like to find out more about our robotic assisted knee replacement surgery, please contact Jenny Baron at jenny.baron1@nuth.nhs.uk , Nicholas Aitken at nicholas.aitken@nuth.nhs.uk or call 0191 22 31514

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