You will be asked to provide your surgeon with information regarding:

• Your general health
• Medications that you are taking – especially oral contraceptives, steroids, aspirin
• Allergies
• Previous operations
• Bleeding disorders
• Other bone and joint problems

A number of investigations will be carried out before the operation. Some blood tests and X-rays are generally required. You may be referred to a Specialist Physician or Anaesthetist to optimise your fitness for the operation.

• The operation takes one to one and a half hours
• The incision overlies the front of the knee joint
• Antibiotics will be given to you in the operating theatre
• You will have an intravenous drip inserted into your arm and a urinary catheter to help you pass urine during and after operation
• The operation will normally be performed under epidural anaesthesia or general anaesthesia or a combination of both

Once you have recovered and can bend your knee enough to go home, your surgeon discharges you. Most patients are able to go home five to seven days after the operation. You will be given instructions regarding exercises and medications before you discharge. You should feel free to ask your discharge nurse any questions you may have. You should have appointments made for outpatient physiotherapy and a post-operative visit to your surgeon before discharge.

Do take note:

• The exercises you carried out during your hospital stay should be continued at home. These exercises are aimed at improving mobility and strength of your knee. You require crutches as long as your surgeon advises you
• You should visit your physiotherapist as arranged after your discharge from hospital. He will check your progress and advise you on any additional exercises you may require
• Your surgeon will see you within a fortnight of the operation and your stitches will usually be removed at the stage. He will also assess your ability to walk, the mobility, strength and stability of your knee. He will then advise you on how you can get to the next level of function
• You are capable of driving a car 6 weeks after the surgery. You may walk any distance within your comfort. Swimming is permitted and indeed encouraged. Activities such as dancing, golf and bowling can usually start after 2 months
• Your knee will serve you well and painlessly if you are able to put in the time for the exercises. The new knee should last for many years if you exercise reasonable caution. Heavy impact sports, jumping and violent twisting of the joint can cause early failure

Total knee surgery is now safe and effective as total hip surgery. However, there are definite risks and complications associated with the operation of Total Knee Replacement. Although they are rare, and your orthopaedic surgeon and the hospital staff will do their best to try and prevent these complications from occurring, unfortunately, they can occur. Some of these complications are:

• Anaesthetic Complications
• Infection
• Deep Venous Thrombosis and Pulmonary Embolism
• Loosening
• Stiffness
• Wound Complications
• Fat Embolism
• Pressure Sores
• Vessel and Nerve Injury
• Fractures
• General Medical Problems

If you get an infection anywhere in your body, (e.g. skin, urine, chest, throat, teeth), the infection can get into the blood stream and spread to your knee. Therefore, call your doctor:

• Before you have any dental work
• Before any other operation or invasive procedure, e.g. Endoscopy, Sigmoidoscopy, Urinary Catheter, Gynaecological Procedures
• If you suspect you have an infection anywhere
• If your wound becomes red, hot, swollen, more painful or discharges any fluid

Do :

• Do always use your crutches when you walk until told otherwise
• Do walk frequently on level ground when you go home
• Do follow the directions given to you at the hospital
• Do ring your doctor if you are worried

Don’t :

• Don’t drive a car until your doctor gives you permission
• Don’t bend your trunk forward more than 90 degrees when sitting or standing
• Don’t cross your leg whilst sitting or lying down
• Don’t twist at the hip – turn your whole body
• Don’t sit on low chair, use a firm highchair with arms

Robotic technology is used to create a 3D virtual module of your bone (knee or hip) with imaging like CT scan or X-ray. It will provide details on the bony anatomy of an individual patient and enable the orthopaedic surgeon to pre-plan your surgery with a unique software. The software can assess the resection margin and virtually place the implant in the proper position with best assess of joint balance, bend and rotation. This pre-op plan can be implemented during surgery.

During surgery, surgeons will do the bone registration; identify landmarks in order to fuse the actual bone view and the pre-op plan. There is an optical tracker to track the joint movement during surgery. The pre-op plan overlaid on the actual bone is used as a surgical guide, to provide information on where to cut and how much to cut then place the implant in pre-defined area. Surgeon can make adjustments if necessary during the surgery.

Robotic-assisted surgery can deliver high accuracy in implant placement, minimise soft tissue and ligaments injured of the knee and hip, and prevent unnecessary bone cuts, thus leading to less post-operative pain. With this, patients experienced shorter hospital stay, lower complication rate and faster recovery. Due to the high accuracy in implant positioning, it can result in a more natural-feeling knee after surgery and the potential for better long-term satisfaction and implant durability.

To date, our 9 orthopaedic surgeons has performed thousands of robotic joint replacement surgeries. Our team is first in the country to do the robotic hip replacement with Mako SmartRobotics in 2021 and robotic partial knee replacement with ROSA Knee System in 2023. We strongly believe that the revolutionisation of robotic technologies can enhance precision and thus improve patient outcomes in orthopaedic procedures.