Robotic Total Knee Replacement

We need balance in our life. We need balance in our knees.

Robotic total knee replacement technology guides surgeons with precision accuracy to make sure the knee joint is aligned perfectly for the best possible long-term function.

Dr. Scott Appell has extensive experience with Zimmer Biomet’s ROSA robotic knee platform, both as a surgeon and as an educator of students learning the benefits of robotics and advanced computer software in orthopedic practices.

He and his team devote an equal amount of attention to the latest advances in pain management. His Enhanced Recovery After Surgery (ERAS) approach, which avoids narcotics during surgery and addresses pain management with minimal to no opiates, enables patients to recover quickly, be active immediately, and resume independence as soon as possible.

In addition to robotic total knee replacement, Dr. Appell’s areas of expertise include minimally invasive anterior hip replacement, partial knee replacement, and total shoulder replacement. He and his team achieve consistently excellent results with predominantly outpatient joint replacement, which allows most patients to return home the same day, fully prepared to manage their recovery with the team’s support.

If you would like to schedule a consultation with Dr. Appell, please call (205) 397-5200 or book an appointment online.

Robotic Total Knee Precision

The most important goal for a total knee replacement is to achieve balance.

When a knee is out of alignment ─ even to a degree not detectable using traditional, manual techniques ─ it can wear out faster. The slightest amount of instability can put stress on ligaments and tendons that causes knee pain and discomfort.

Robotic knee technology guides surgeons with precise measurements and 3D visualization that ensure knee alignment is precise and accurate.
Computer-generated numbers identify correct knee flexion and tension.
Real-time data validates that ligaments are balanced throughout flexion and extension, so the knee can move and function properly.

Robotic Total Knee Procedure

Finding the right soft-tissue balance with traditional instruments can be highly subjective. The robotic knee platform allows surgeons to accurately measure soft tissue response and conduct a knee replacement virtually before making any surgical cuts.

Dr. Appell and his team spend close to 45 minutes on a robotic total knee surgery, paying close attention to detail to make sure all of the numbers align perfectly for the best possible outcome.

In the planning screen, the team receives live feedback on soft-tissues, rotation between the hip and knee joints, and ligament tension.
The robot allows the surgeon to move the knee and create tension and stress in each direction before cutting the bone.
A 3D model provides dynamic patient data and measurements throughout the range of motion.
Robotic experts help collect and utilize all relevant numbers and data points.
The robot guides surgeons to make micro adjustments to the angle and positioning of bone cuts to ensure ligaments will be balanced.

Enhanced Recovery After Surgery

Dr. Appell and his team utilize an Enhanced Recovery After Surgery (ERAS) system developed by the ERAS Society to minimize opiate use, reduce recovery time and improve patient outcomes.

This begins with educating patients thoroughly to make sure they understand what their surgery entails, what to expect when they return home, and the general timeline for recovery.

Spinal anesthetics allow Dr. Appell’s team to operate without narcotics.
Propofol puts patients in a twilight stage.
Spinal anesthetics last for two hours so that patients don’t wake up in pain
Eliminating narcotics eliminates the post-op nausea and vomiting that has prevented people from going home post-surgery.

Post-surgery pain management:

A nerve block injected into the knee reduces pain for 48 to 72 hours after surgery.
Nerve medication, Tylenol, and non-steroidal anti-inflammatory drugs (NSAIDS) limit the need for opiates.
An icing machine, connected to a wrap that encircles the leg, pumps ice water around the knee to reduce swelling.

Rapid Recovery Timeline

Patients are up and walking immediately after surgery.
Close to 95% of robotic total knee patients go home the same day.
Patients are able to climb stairs right away and get around with a walker until they stop limping.
A follow up visit at 3 weeks will determine if a patient is ready to drive; a patient with a left knee replacement may be able to drive after 10 days.
Physical therapy will focus on range of motion; using a nerve block used during surgery enables patients to achieve 110 degrees of flexion on the first day after surgery.

Few Restrictions

Three to six months after total knee replacement, most patients say they don’t think about their knee anymore, and have resumed all normal activities with greater mobility and comfort.

There are a few things to consider:

The implant will set off metal detectors at the airport.
You should avoid extreme, high impact sports such as aggressive basketball or parachuting.
Patients are free to resume golf, tennis, biking, hiking, and most other low impact sports.