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Hundreds of thousands of Americans undergo partial or total knee replacements each year. Advanced techniques, including robotic-assisted technology, have helped to improve long-term outcomes for patients.

One advanced technology, the VELYS™ Robotic-Assisted Solution, uses real-time data to allow for patient-specific knee replacements based on their anatomy.

The technology was previously available for total knee replacements. However, UPMC surgeons are also now using it for partial (or unicompartmental) knee replacements.

“I think the technology is as good as it has ever been,” says Kyle Hubler, DO, orthopaedic surgeon, UPMC in North Central Pa. “Specific to the robotic technology, our goal has always been for the patient to have a good outcome: to give them a painless, functional knee so they can get back to their day-to-day activities, work, leisure, sports, without hurting all the time.”

Learn more about how robotic-assisted technology is helping with knee replacements.

What Are the Compartments of the Knee?

The knee has three compartments:

• The lateral compartment — The outside of the knee.
• The medial compartment — The inside of the knee.
• The patellofemoral compartment — The front of the knee, located between the patella (kneecap) and femur (thighbone).

In a total knee replacement, a surgeon replaces all three compartments of the knee with artificial implants. In a unicompartmental (partial) transplant, the surgeon replaces only the damaged portions of the knee with artificial implants.

Partial knee replacements are more common in younger patients, according to data from the American Academy of Orthopaedic Surgeons.

“I do think that there are patients who can benefit from the unicompartmental knee replacement,” Dr. Hubler says. “For example, some of our younger, active patients, or someone who has arthritis in one specific compartment of their knee that has also failed conservative measures. They can benefit from the unicompartmental knee replacement.”

How Does Robotic-Assisted Knee Replacement Work?

The VELYS system collects real-time data based on a patient’s anatomy to allow for tailored knee replacements. It includes the robotic unit, navigation pins, a high-speed camera, and data screens to assist the surgeon.

After making the incision, the surgeon places the navigation pins into the bone around the knee joint. The pins work with the camera to deliver real-time data about the knee’s anatomy.

“We take many, many landmarks to register the patient’s own unique anatomy,” Dr. Hubler says. “We check their motion, which gives us real-time data about their ligament balance, their motion, and their deformity.

“We’re able to create a map of sorts, or a plan, to correct those deformities and give the patient the best possible balance and range of motion based on their specific deformity and anatomy.”

The data collected allows surgeons to know how much bone and cartilage they need to remove.

“How it might benefit them is by giving them an outcome that is as accurate as possible in terms of their alignment, bony resections, and ligament balance,” Dr. Hubler says.

What Are the Benefits of Robotic-Assisted Partial Knee Replacement?

In general, partial knee replacement includes many benefits compared to total knee replacement. The benefits include:

• A smaller incision.
• Less blood loss.
• Less pain after surgery.
• Lower risk of complications, including infections and blood clots.
• Quicker recovery.

“It is a faster recovery. It feels more like a normal knee, like your own,” Dr. Hubler says. “The unicompartmental surgery traditionally has had good outcomes for the right patient.

“And one of the things that we have learned is that the better ligament balance we achieve through the surgery and the implant, and the more bone we can preserve during their surgery, the better the patient’s chance of having a good outcome is.”

The robotic-assisted system helps achieve that by giving surgeons data on the patient’s unique anatomy. That can help them determine how much cartilage and bone they need to take out. Those bone-saving measures will also lead to lower risk if the person eventually needs a total knee replacement.

The device carries other benefits, Dr. Hubler says. For example, preoperative imaging, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans, is unnecessary. This saves time, money, and does not expose patients to radiation.

Patients also can expect the same surgical experience, Dr. Hubler adds.

“Their incision is the same, their hospital stay is the same, how they feel, their recovery — that doesn’t change,” he says. “We’re taking a different road to get to the same good outcome.”

When Should I Talk to a Doctor About Knee Replacement?

Osteoarthritis is the most common cause of partial and total knee replacement. Typically, doctors will first recommend nonsurgical treatments for knee pain, including:

• Activity modification.
• Lifestyle changes, including diet and exercise.
• Over-the-counter pain medications.
• Pain-reducing knee injections.
• Physical therapy.
• Weight loss.

If conservative treatments do not help your pain, and your pain is affecting your daily life, you may be a candidate for knee replacement.

“I tell patients that, ‘You’ll be telling me, I won’t be telling you,'” Dr. Hubler says. “And it’s when they’re at that point where they’re avoiding doing things that normally they would want to be doing, that’s when I think it’s time.

“Other reasons that we would push someone to go the surgical route are if their arthritis is leading to a significant deformity or instability in the knee, where maybe they’re a fall risk. Those are also reasons when surgery can benefit them.”

Dr. Hubler says he discusses options with each patient, including robotic-assisted surgery. While some patients may not be a candidate for robotic-assisted surgery, many are, he says.

Why Choose UPMC for Knee Replacement Surgery?

UPMC orthopaedic surgeons have access to the latest techniques and technology for knee replacement surgeries.

In addition, advances in anesthesia and physical therapy are helping patients have better outcomes, Dr. Hubler says.

“We would advocate for patients to come here just based on the whole experience,” he says. “I think that our team of experts — and not just the surgeon, but the physician assistants, the nurses, the physical therapists — our team is trained in the latest techniques with the surgery, the recovery process afterwards, with the ultimate goal to have the best possible outcome for the patient.”

UPMC Orthopaedic Care has locations throughout the entire region UPMC serves. To find a provider near you, visit our website.