Aorangi Surgical Group (ASG) Website - Mark Cvitanich Orthopaedic Surgeon

About robotic knee replacement surgery

VELYS Robotic-Assisted Solution for Knee Replacement - Mark Cvitanich

The VELYS Robotic-Assisted Solution for knee replacement is an innovative and advanced knee system that streamlines total knee arthroplasty, commonly known as total knee replacement surgery. Mark has the option to use the Velys Robotic-Assisted solution for his Total Knee Replacements.

Tthe VELYS Robotic-Assisted Solution has been developed as a groundbreaking surgical table-mounted system. It seamlessly integrates into the surgeon's workflow, employing advanced planning capabilities, proprietary technology, and a cutting-edge design to assist surgeons in precise bone cuts and proper implant alignment during total knee arthroplasty, eliminating the need for pre-operative imaging.

The VELYS Robotic-Assisted Solution exclusively works with the ATTUNE Knee System, which has been shown in studies to improve patient-reported outcomes, clinical outcomes, and contribute to shorter hospital stays. By supporting the "patient-specific alignment" operative method, the VELYS Robotic-Assisted Solution assists Mark in providing individualized knee alignment tailored to each patient's unique knee anatomy. Together with the ATTUNE Knee System, the VELYS Robotic-Assisted System offers comprehensive solutions for personalizing the knee replacement process, encompassing surgical planning, implementation, preoperative patient engagement, and post-operative support.

Indications for the VELYS Robotic-Assisted Solution for Knee Replacement

The VELYS Robotic-Assisted Solution is indicated for use with the ATTUNE Knee System for total knee arthroplasty. This surgical procedure involves removing the worn-out or damaged surfaces of the knee joint and replacing them with an artificial prosthesis. Mark may recommend the VELYS Robotic-Assisted Solution if you have one or more of the following conditions:

Chronic progressive joint diseases like osteoarthritis and rheumatoid arthritis
Severe trauma or fracture to the knee joint with secondary osteoarthritis
Unsuccessful non-surgical treatment of the above conditions

Preparation for the VELYS Robotic-Assisted Solution for Knee Replacement

Preoperative preparation for the VELYS Robotic-Assisted Solution for knee replacement may involve the following steps:

A comprehensive examination by your surgeon to address any medical issues before surgery.
Depending on your medical history, tests such as blood work and imaging may be necessary to identify any abnormalities that could affect the safety of the procedure.
Inform your doctor about any allergies, medications, or underlying conditions you have.
Discontinue certain medications, such as blood thinners or anti-inflammatories, as advised by your doctor.

Procedure for VELYS Robotic-Assisted Solution for Knee Replacement

Typically, the VELYS™ Robotic-Assisted Solution for total knee replacement is carried out while you are under general anesthesia, alongside the ATTUNE® Knee System that is quite similar to a traditional total knee replacement. However, it is performed with the aid of a robotic assistant. It's worth noting that the robotic system doesn't carry out the procedure independently. Instead, the surgery is wholly executed by Mark. He does this by directing the robotic hands according to the individualized plan that he has put together for you. The VELYS™ Robotic-Assisted Solution is only an additional tool to guide him to ensure greater accuracy in the placement of knee implants.

Risks and Complications

VELYS™ Robotic-Assisted Solution for knee replacement is a relatively safe procedure; however, as with any surgery, there are potential risks and an orthopaedic surgeon can determine if knee replacement surgery is an option for the patient. Results may vary for the patient and depend on numerous factors, including age, weight and activity level.

Direct Anterior Approach Hip Replacement (DAA)

Direct Anterior Approach for Total Hip replacement - Mark Cvitanich

Arthritis of the hip joint results in damage and wear of the articular cartilage covering the hip joint surface leading to inflammation and severe pain in the hip. The end stage treatment of arthritis involves replacing the hip joint through surgery. Mark provides diagnosis and treatments for hip arthritis including anterior hip replacement surgery

The Direct Anterior Approach hip replacement is an approach that I utilise for my total hip replacements which is a good alternative to the traditional posterior or lateral approaches. These other approaches involve cutting the muscles surround the hip to access the joint.

In contrast, the direct anterior approach uses a muscle interval at the front of the joint so as to avoid the cutting of any muscles. Patients, therefore, experience less pain during the early postoperative period. The other major advantage is that patients do not need any postoperative precaution for posterior hip dislocation like using a highchair, high toilet seat or sleeping flat on the back for 6 weeks.

The surgery takes about an hour with either a spinal or a general anaesthetic. The surgery is done with you lying on your side not requiring the use of a special table.

We get you up immediately after the surgery. You will usually be up and walking within 90 mins of your surgery. Most patients will be discharged home the next day with the rest staying another night. You will be off crutches in the second week postoperatively. You can drive your car once off the crutches. You can sleep on your side immediately after surgery. A waterproof dressing covers the glued skin wound which allows showering immediately.

Benefits

Advantages of the direct anterior approach include:-
Smaller incision
Short operative time
Minimal blood loss
Short stay in hospital
Less postoperative pain
Quicker mobilisation
Fewer postoperative restrictions
Lower dislocation risk
Quicker return to driving/ work normal activities

Risks

No surgery is without risk. For a hip replacement, complications whilst unusual, can occur in about 2-3% of patients. The main complications to be aware of is infection which can occur early as a result of bacteria getting into the wound from your skin at the time of surgery. We minimise this risk by a strict sterile environment, special airflow in theatre and antibiotics around the time of surgery. Despite all efforts about 1% of patients will get an infection which may need further surgery to remove the implant and replace it with a new one to clear the infection. Dislocation is very uncommon and can usually be put back in place with sedation or a general anaesthesia. Recurrent dislocation may require further surgery to stabilise. Fracture can occur with any bone surgery and we have the gear available should this occur during the surgery. Deep vein thrombosis is very rare as we get you up so quickly and encourage lots of walking. I do put you on aspirin for 6 weeks postop. Some patients can get a temporary numb patch on the lower thigh from slight stretching a skin nerve during the surgery.