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What is Joint replacement & when its recommended?

Joint replacement is a surgical procedure in which parts of an arthritic or damaged joint are removed and replaced with a metal, plastic or ceramic device called prosthesis.

Several conditions like arthritis, a fracture or trauma, injury to joints can cause joint pain and disability and lead patients to consider joint replacement surgery.

If nonsurgical treatments like medications, physical therapy, and changes to your everyday activities do not relieve your pain and disability, your doctor may recommend total joint replacement.

What are the latest technologies used in Joint replacement surgery?

Joint replacement surgeries across the world have evolved with different technological advances to ensure better patient outcomes. There are different ways of doing joint replacement surgeries

  1. Conventional methods
  2. Computer assisted / Robo navigated systems (Robotic)
  3. Advanced Computer navigated systems with imaging tools (Personalized)



What is Computer assisted & Robonavigational joint replacement surgery?

Studies have shown that proper alignment in both hip and knee replacement can lead to improved postoperative outcomes including postoperative function, postoperative pain, and improved longevity of the implant.

Computer-navigated and robotic-assisted total joint replacement has been introduced over the last two decades.

Robotic systems assist the surgeon in executing the surgery by transferring the pre-operative imaging data and templating to a robotic surgical assistant with an articulating arm that attaches to the surgical instrument or implant.

What is ROBOALIGN technology?

ROBOALIGN is a Revolutionary technology which integrates 3D technology & Artificial Intelligence to make JOINT replacement more personalized.

The world today is full of choices, courtesy of technological advancement. Knee Replacement surgeries have evolved with changing times and needs.

RoboAlign is a pathbreaking technology that uses 3D capabilities to develop 3D bone models to offer unmatched perfection, precision and ease in implant selection well before surgery.


  • RoboAlign is a 3D imaging based total knee instrumentation system. It helps to give Accurate 3D Dimensions X, Y, Z Axis, and most important it gives you the perfect size of the implant before you measure the sizes during the live surgery.
  1. Imaging Software – Pre-operative Planning with 3D models:

The CT scans are used for 3D imaging. A 3D virtual bone model is generated within 1 mm accuracy. The planning part of the system has a very, user-friendly (surgeon-friendly) interface. It allows the surgeon to view the 3D bone model in four-window format with simultaneous views of all axes with images as well as the 3D bone model. The system’s algorithm generates the anatomic and mechanical axes and the posterior axes.

RoboAlign provides preview of the anatomic landmarks with the axes and the values of valgus angle of distal femur and distal femoral rotation.

The surgeon/user then has to put the 3D model of desired implant (which are stored in the system) on 3D bone model of the patient. The system calculates the sizes cuts. It allows the user to change the implant, size of the desired implant and position of the desired implant. Thus, the surgeon/user can customize the implant and its position for the individual patient in three dimensions.

2. Modular Instruments (JIG)

The instrumentation is devised on the principles of precise knowledge of the sizes of distal and posterior cuts derived from 3D planning. A JIG of the desired size is used to achieve precise varus-valgus position. The instrumentation is modular and can be assembled on the back-table. It allows saving time while maintaining high level of accuracy. Moreover, as it is modular, it can be assembled in another unique way for another patient without extra burden of cost.

RoboAlign allows 3D planning for customizing the best fit implant design, size and position for the individual patient.

In conventional technique, the surgeon takes the cuts perpendicular to the intramedullary rod in the sagittal plane. Also, the precise mechanical axis is difficult to judge from X-rays and mostly an arbitrary angle is chosen.

The same is true for femoral rotation. With Kne3wiz, no intramedullary violation is necessary. Hence, the load of instrumentation required drops down significantly.


A complete 3D solution, highly accurate TKR surgery process which overcomes the problems faced by conventional and modern TKR surgeries.

The high accuracy provided by the system coupled with the 3D bone model helps in determining the best fit implant.

Highest accuracy and the best fit are guaranteed because once the 3D model is developed, different implants can be tried on the bone model to check the best fit and position of the implant.

Flexibility in selecting implants specific to the individual patients
A perfect fit ensures that the patient won’t have to deal with commonly associated problems that come up after conventional total knee replacement – persistent pain after a few years and issues with function and motion.

The accuracy of the system combined with its cost and time-saving process leads to higher patient satisfaction and maximum success ratio among all other competing knee replacement techniques.

Compared to the overall benefits provided by the system in terms of cost and time saving, the initial investment in the software is relatively expensive, especially considering the glowing recommendations that your patients will continue to provide for years to come.

How your robotic system is different and what benefits it offers?

Robonavigation system which we use is German engineered PINLESS Computer Navigation System for Total Knee Replacements. This is wifi enabled, uses artificial intelligence to provide précised information, helps to achieve perfection, zero error in placement of implanted artificial knee has assured results and is affordable.

Most routine knee replacements worldwide are done using alignment jigs and cutting blocks. These are relatively simple devices that rely on the surgeon’s ability to see and feel the alignment and balance of the knee. Research shows the common methods have their shortcomings in terms of proper placement of joints. A well- aligned and properly balanced replaced knee is more likely to last longer. Although computer navigation for knee replacement has been around for some years, it really never became popular. The earlier versions required drilling extra holes, to attach sensors. These extra pin holes in femur and tibia could sometimes cause serious complications like pin tract infection, fractures and sometimes damage to arteries and nerves.

The newer version is PINLESS Robot Navigation does not require drilling extra holes in leg bones, totally avoiding these serious complications. A perfectly aligned Knee not only lasts longer, it allows the patient an early recovery. The patient can start walking as early as 4 hours. Another big advantage is the as the surgeon is guided by computer Navigation, he can perform this surgery by making small incisions thereby expediting recovery.

The PINLESS Computer Navigation Technology provides real- time, 3-D imaging and guides the surgeon’s cuts. It also confirms the accuracy of the cuts. This allows the surgeon to accurately place implants and align the leg. Errors in techniques that may otherwise go unnoticed can be quickly seen and corrected. Thus, PINLESS Computer Navigation used during Knee Replacement helps to ensure proper positioning of the implants. This is a big boon for the patients with deformities around knees, undergoing knee replacement.

Nowadays there is a lot of emphasis on long lasting knee implants. But any knee implant will fail if not aligned properly in the knee joint. With PINLESS Computer Navigation Technology, we can give the patient a new knee that has the option position, strength, stability, and range of motion, even in difficult anatomic situations


  • Stitchless & Pinless Surgery
  • No general anesthesia required
  • Reduction of errors in rotational and translational alignment
  • Improved position accuracy and fit of the new implant
  • Reduction of complications
  • Reduction of bone sacrificed to fit the new implant
  • Reduction of cumulative exposure to x-ray radiation
  • Shortened hospital stay and operating time
  • More accurate placement of the implant,
  • Shorter hospital and recovery times

What is anatomical joint and how this procedure is done?

Successful total knee arthroplasty (TKA) has often been based on the restoration of the knee to neutral alignment postoperatively. Numerous reports have linked malaligned TKA components to increased wear, poor functional outcomes, and failure

Anatomical Alignment places the overall component alignment at 2°–3° of varus in relation to the mechanical axis of the lower extremity.

The goal of this alignment is to co-align the 2 transverse axes by providing the most adequate shape fitting in order to achieve a “more natural” knee kinematics.

Computer navigation has been around a while in the operating room, but what separates this procedure from others is that it’s less invasive for patients.

There is an infrared tracker that is used to communicate with a camera. The Navigation system uses an infrared camera and instruments along with unique tracking software to continually monitor the position and alignment of the implant components in relation to the patient’s anatomy.  Smart wireless instruments send data pertaining to the kinematics (movement) to the computer.

The computer analyzes and displays data on a computer monitor in the form of charts and graphs that supply the surgeon with the angles, lines, and measurements needed to accurately align the prosthetic knee with the patient.  It’s like having a GPS System in the operating room. With it, we can give a patient a new knee that has the optimal strength, stability, and range of motion, even in difficult anatomic situations.

How long patients can keep these joints? Do they need revision surgery?

The joints replaced with anatomical kinematic process has life of almost 40 years and there is hardly any need to go for revision surgery.

People say after joint replacement surgery you cant be flexible as natural joints?

Agree to the fact that the mechanical methods of joint replacement, which is done by majority of the doctors, has this limitation of movements post surgery.

With anatomical kinematic Robo-navigation joint replacement we ask patients to perform the tasks which they were not able to do earlier. Our patients are comfortable doing their daily rituals including using Indian toilets, riding bike, working in farm, doing Namaj, performing Puja by seating etc.

So with the help of artificial intelligence & advanced technology we are able to give patients their full life back.

How you ensure early recovery of your patients post surgery?

Recovery is another big challenge after any surgery. Every surgeon wants less post op complications, no infection & patients going to their routine life as early as possible.

Post surgical Success depends on skills of a surgeon, use of technology & post op care & treatment.

With our patients we ensure to use best technology for precision & accuracy so we avoid complications.

Patients are advised proper physiotherapy & daily exercise. We advise every patient to take appropriate nutrition to reduce pain, strengthen muscles and regain energy.

This also avoids dependency on drugs like pain killers. Our patients are on their feet Day 1 and start walking on 2nd day of surgery & most importantly are able to conduct their regular activities pain freely and are healthy and happy once they goes back.

What message you would like to give for people to keep their joints healthy?

Joints are the important part of our body which keeps our flexibility & movement. Joints need proper nutrition & regular exercise to keep them fit & healthy. Everyone should practice both.

Also would caution about mushrooming of surgeons making false claims that they perform computer navigation knee replacements. The best way to ensure that your patient has undergone computer guided knee replacement is to ask your surgeon to provide a computer navigation report of your patient.

Do not fall for wrong promises. Every robot is not same & anatomical kinematic joint replacements can’t be performed with every robot. There is specific robot with which this surgery is performed, so verify about type of robot doctor is using & then opt for it.

  1. Source: Department of Research & Scientific Affairs, American Academy of Orthopaedic Surgeons. Rosemont, IL; AAOS; May 2014
  2. Current Review of Musculoskeletal Medicine 2014.
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