Written by Mr Reza Jenabzadeh for Doctify

Orthopaedic Surgeon Mr Reza Jenabzadeh provides us with a complete guide of to what to expect from computer navigated hip and knee replacement.

What is computer navigated joint replacement?

The concept of computer navigation in surgery is well established. It is used more frequently by neurosurgeons performing intricate brain surgery. This technology allows the surgeon to simultaneously visualize 2 or 3-D views of the patient’s anatomy on a monitor, and provide real-time, intra-operative views of surgical instruments and the relative digital positioning of implantable devices.

Computer navigated hip and knee replacements are performed in a selected number of NHS or private hospitals in the UK. It is important to stress that computer navigation acts as a guide for the surgeon – it’s not the same as robotic surgery, where the computer helps control the movements made by the surgical instruments.

How does computer assisted navigation work?

This is essentially a ‘mini GPS system’ used by the surgeon during a hip or knee replacement. It uses infra-red technology to ‘align the components properly’. It allows the surgeon to create and execute a surgical plan that will lead to minimal tissue disruption and less bone removal.

What surgeries can computer assisted navigation technology be used for?

It can be used for total knee replacement, partial (unicompartmental) knee replacement, total hip replacement and revision hip replacement.

How new and innovative is this technology?

This technology was first introduced about 15 years ago, meaning that it is well-established and not ‘experimental’. Navigation has evolved over the past 15 years and is now the ‘cutting edge’ technology used in joint replacement.

What are the benefits of using computer assisted navigation compared to traditional surgery techniques?

Computer navigated surgery improves the precision of implant placement – alignment, soft tissue balancing and restoring mechanical axis of the lower limb. The signs are that this leads to a much better functional result for the patient.

  • Reduces risk of revision surgery.
  • Reduces risk of outliers (incorrect positioning).
  • Reduces risk of leg length inequality in hip surgery.
  • Reduces risk of fat embolus and blood loss in knee surgery.
  • One can reduce the size of incision and soft tissue damage.

Are you less likely to need revision surgery if you undergo computer assisted navigation surgery?

Yes – The Australian registry is the only registry in the world that looks at computer navigation and it has shown that the use of navigation reduces the risk ok revision surgery.

What type of patient would benefit from computer assisted navigation surgery?

Any patient undergoing hip or knee replacement will benefit from computer assisted surgery.

Complex cases – severe deformity, obesity or previous long bone fractures.

What are the main questions patients ask when considering this type of surgery?

Most patients see the benefit of using computers in their day to day lives and find it logical that they can be used to improve outcomes.

Most patients want to know the surgeon’s experience in using this technique as specialist training is required.

Are there any risks or complications compared to traditional surgery?

No – computer navigation actually reduces the risk of a fat embolus or bleeding with total knee replacement.

What will recovery be like? Is recovery any different than a traditional surgery?

Recovery should be no different to traditional surgery. The patient will start walking with the aid of crutches / frame the day after surgery. They will need this for anything up to six weeks.

Patients with unicompartmental knee replacements find that their knee feels ‘more natural’ and has a greater bend.

 


 

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