Dr Manuj Wadhwa
For years, traditional knee replacement surgery has relied on bone cement to secure implants, a method that has proven effective for many patients. However, advancements in orthopedic surgery are continuously reshaping how we approach knee replacement, introducing a revolutionary technique: cementless total knee replacement. This innovative approach, championed by experts offers a more natural, durable, and precise solution, particularly beneficial for younger and more active individuals.
What is Cementless Total Knee Replacement?
Cementless total knee replacement combines two cutting-edge technologies to achieve superior outcomes. This ground breaking advancement is “reshaping how we approach knee replacement”.
Firstly, cementless fixation is employed instead of bone cement. These implants are designed with a special porous or textured surface, often made from advanced materials like titanium, and sometimes enhanced with a hydroxyapatite coating. The unique aspect of this fixation is that your own bone naturally grows into these surfaces, forming a strong, biological bond that securely holds the implant in place. This biological fixation is believed to offer greater durability and longevity compared to traditional cement.
Secondly, robotic assistance plays a crucial role in achieving unparalleled accuracy. With systems like CUVIS, robotic technology provides unparalleled precision. It allows for the creation of a highly detailed 3D map of the knee, enabling incredibly precise surgical planning and flawless execution. The robotic arm assists in making exact bone cuts and placing the implant in the optimal position, perfectly tailored to the patient’s unique anatomy. This level of precision is virtually impossible to achieve with the human hand alone.
Transformative Advantages
The combined approach of cementless fixation and robotic assistance offers truly transformative advantages for patients:
Potential for Long-term Durability: By fostering a biological bond with the bone, cementless implants aim for increased longevity, significantly reducing the risk of implant loosening, which is a common reason for revision surgeries.
Bone Preservation: This technique preserves more of the natural bone stock, which can be a significant advantage if any future revisions are needed.
Reduced Complications: Potential issues associated with bone cement, such as allergic reactions or cement fragmentation over time, are eliminated.
Shorter Surgical Time: The surgical procedure itself can be quicker as there is no need to wait for cement to set.
Faster Recovery and Less Pain: Robotic precision leads to minimal soft tissue damage and a better fit, often resulting in less post-operative pain and enabling a quicker return to mobility. Experts have has seen patients taking their first steps on the very same day of surgery.
More Natural Feel: Advanced implant designs, such as the medial pivot cruciate-retaining design, aim to mimic the natural movement of the knee, leading to a more comfortable and functional joint.
Ideal for Active Individuals: This method is particularly beneficial for younger, more active patients who place higher demands on their knee implants, as their robust bone quality supports optimal bone ingrowth.
Important Considerations
While the benefits are profound, careful patient selection is crucial. Cementless total knee replacement is best suited for individuals with good bone quality. It may be emphasizes, “Your surgeon’s experience and expertise are also paramount, as the precision required for cementless implants leaves no room for error”. Initial stability is achieved with special pegs or screws while the bone grows into the implant, and while the healing time for bone ingrowth can be slightly longer, the long-term benefits often outweigh this.
Cementless robotic knee replacement represents a significant leap forward in orthopedic care. It offers a durable, bone-preserving, and highly precise solution that can restore mobility and significantly improve the quality of life for suitable patients. If you are experiencing knee pain and considering replacement surgery, encourage you to explore whether this advanced technique is the right option for you, by consulting with an experienced orthopedic surgeon.
(The author is Chairman& Executive Director, Elite Institutes of Orthopaedics & Joint Replacement Livasa Hospital Mohali)
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