Difference between Robot-Assisted TKR and Conventional?

In April 2017 I had a right total knee replacement (TKR) performed by Dr. Ortiguera @ Mayo Jacksonville. I was pleased beyond belief at the results. On 1/29/19 (last Tuesday) I had a left TKR, again performed by Dr. Ortiguera. This time, he used the robot-assisted technique. Prior to the surgery, Dr. O talked to me about his expectation that the greater degree of accuracy and precision might result in a quicker recovery and less pain. I had high expectations for this surgery and so far I am astounded! Before surgery I had 3 degrees extension/130 flexion. I had 3 PT visits in the hospital. On the last one before discharge, I had 5 degrees extension/110 flexion. I still need my RX pain meds, but the first night home, I slept 6 full hours before the pain woke me up. And, on my first in home PT visit, I was walking so well with the walker that the physical therapist let me try the cane, I was strong enough to go back and forth across the LR with just a cane. I am SO pleased with the results I'm seeing. (At this point, my only complaint is that I'm still having a bit of nausea and brain fog from the meds!) Has anyone else had this kind of experience with the robot-assisted TKR? If so, I'm wondering how your PT was different and also how long you stayed in PT after the surgery?

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I took this for you, Joe

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@cindymattern

I had the typical TKR and not robotic. I think it depends on the surgeon. Mine has done thousands of TKR and I am happy. The first few months were hard. At 7 months I'm doing everything I did and more. Yes, I still do too much and get sore by the end of the day but I'm getting stronger and things are moving along. It takes 6-12 months. yesterday I got on my hands and knees on the floor and got up on my own. I have no numbers anyplace and all my feeling has come back as well. My opposite foot Think has some issues with the top and ankle hurting but I might have favored it some. It's ok to be apprehensive. Just make sure you have a really good surgeon that I think that is the main key. You've got this.

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When did the stiffness ease up?

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@scochran

When did the stiffness ease up?

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It started easing up around the 3 month mark. I still have stiffness and soreness if I overdo but I've been told 12 months. I'm at 7 months, have walked over 4 miles and around 10,000 steps if that helps. I ice at night before bed and wake up stiff but everything is stiff until I get moving as I'm 61 and have some arthritis everywhere lol....The further out I get the stiffness gets better. I know that I'm much stronger than I was. I do have a knee sleeve and this helps tremendously when I need some extra support and compression but make sure it's not too tight. You need to be able to bend the knee. I'm doing everything I was prior to surgery now but I am a bit slower because I don't want to fall. They want me to not fall for at least a year and I definitely do to want a revision. Just make sure you have a great surgeon and you will do great if you do the PT (I opted for actually going to PT). I did 3x a week for a month, 2x a week for a month then 1 time a week for another month and exercises at home.

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@cindymattern

It started easing up around the 3 month mark. I still have stiffness and soreness if I overdo but I've been told 12 months. I'm at 7 months, have walked over 4 miles and around 10,000 steps if that helps. I ice at night before bed and wake up stiff but everything is stiff until I get moving as I'm 61 and have some arthritis everywhere lol....The further out I get the stiffness gets better. I know that I'm much stronger than I was. I do have a knee sleeve and this helps tremendously when I need some extra support and compression but make sure it's not too tight. You need to be able to bend the knee. I'm doing everything I was prior to surgery now but I am a bit slower because I don't want to fall. They want me to not fall for at least a year and I definitely do to want a revision. Just make sure you have a great surgeon and you will do great if you do the PT (I opted for actually going to PT). I did 3x a week for a month, 2x a week for a month then 1 time a week for another month and exercises at home.

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Thank you responding. I had surgery back in Feb 2023 and I feel like when I get up first thing in the morning the stiffness isn’t as bad but once I start walking (10-15 mins) it gets worse. So 2 weeks will be 3 months, though I expect some stiffness when I start my day does it ever ease up so I don’t feel like I’m walking without bending my knees? I am in PT as well. I did 3x a week until recently and now I’m 2/week. Any feedback is greatly appreciated. I had bilateral knee replacement as well, don’t think I mentioned that.

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@scochran

Thank you responding. I had surgery back in Feb 2023 and I feel like when I get up first thing in the morning the stiffness isn’t as bad but once I start walking (10-15 mins) it gets worse. So 2 weeks will be 3 months, though I expect some stiffness when I start my day does it ever ease up so I don’t feel like I’m walking without bending my knees? I am in PT as well. I did 3x a week until recently and now I’m 2/week. Any feedback is greatly appreciated. I had bilateral knee replacement as well, don’t think I mentioned that.

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I have heard a total knee is better than a partial knee replacement but I can't really answer to that. Mine was a total. I do have some days where it feels stiff most of the day and I take it easier on those days. I have mine in September 2022 and I can honestly say it gets better each month out for me. You're still early on and to be honest mine felt better after I was done with PT but it's necessary to build their strength and ROM. I don't do exercises like I did when I was in PT but I still try and do them. I'm not sedentary at all and very active. I ride my bike once a day for 15-20 minutes, walk lots and do lots of activity. I think that helps tremendously but I do get sore. The inflammation can continue for a while but I can't take Nsaids for that. I just use Tylenol Arthritis once or twice a day morning and evening. I also can use Voltaren creme topically for inflammation and that helps as well. Keep telling yourself it will get better but I know it is hard early on. I was 7 months yesterday. Looking forward to that one year mark.

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@cindymattern

I have heard a total knee is better than a partial knee replacement but I can't really answer to that. Mine was a total. I do have some days where it feels stiff most of the day and I take it easier on those days. I have mine in September 2022 and I can honestly say it gets better each month out for me. You're still early on and to be honest mine felt better after I was done with PT but it's necessary to build their strength and ROM. I don't do exercises like I did when I was in PT but I still try and do them. I'm not sedentary at all and very active. I ride my bike once a day for 15-20 minutes, walk lots and do lots of activity. I think that helps tremendously but I do get sore. The inflammation can continue for a while but I can't take Nsaids for that. I just use Tylenol Arthritis once or twice a day morning and evening. I also can use Voltaren creme topically for inflammation and that helps as well. Keep telling yourself it will get better but I know it is hard early on. I was 7 months yesterday. Looking forward to that one year mark.

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I appreciate your feedback. It’s been hard to find anyone to provide insight. I did have total bilateral knee replacements in February and I’m expected to go back to work in a couple weeks doing 12 hour shifts. So that’s where my fear is lying right now because of the stiffness and I feel for me after PT the stiffness is worse. At this point I do regret doing both of them but I’m just praying that in time it will get better. Best of luck to you.

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@scochran

I appreciate your feedback. It’s been hard to find anyone to provide insight. I did have total bilateral knee replacements in February and I’m expected to go back to work in a couple weeks doing 12 hour shifts. So that’s where my fear is lying right now because of the stiffness and I feel for me after PT the stiffness is worse. At this point I do regret doing both of them but I’m just praying that in time it will get better. Best of luck to you.

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You’ve got this! You needed the PT fir the first 3 months to get things going. My numbness is all gone now too

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I concur that most important is an experienced surgeon for TKR, whether conventional or robotic-assisted, which is relatively new. My understanding is robotic- assisted creates replacement more specifically fitted to your knee, but don’t do it with an inexperienced surgeon in that technique. I had conventional TKR with no problem but my surgeon had done hundreds of replacements and was well respected.

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@artscaping

Good evening @floodle7252 and welcome to Connect. Our forum is quite special. Why? Because we believe wholeheartedly in sharing information to help everyone build a wealth of knowledge about their condition and how to care for it.

And to answer your question, yes I had a Mako Robotic TKR in August of 2021. It was my second and was amazingly successful with minimal pain and discomfort in recovery. First, it is amazing to see how 3D images can create an easily accessible surgery area. This assures that the surgeon will be able to achieve greater accuracy. It also means that the surgery itself will be minimally invasive.

I started PT the day after surgery and although there was pain, there was also success in building a ROM of 137 and a "0" straight leg. My PT actually worked together with my MFR (myofascial release) therapist to make sure that any pain was minimal throughout the post-surgery period. I was able to drive within a few weeks, go up and down stairs and return to my two-mile walks. The MFR treatments prevent scar tissue buildup.

When you say you have been offered this surgery.......what exactly does that mean? Do you have other choices? My first TKR 10 years ago was a standard surgical procedure and it took almost a year for my new knee to feel like it belonged to me.

You have asked about snapping hamstrings and I must admit that I have never heard that expression. Would you be able to explain that condition to me? Thanks.

May you be free of suffering and the causes of suffering.
Chris

And until we connect again, please have a wonderful Thanksgiving.

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Hi Chris T, Well, it's too late for me. I have my first TKR in 3 days and I am now just finding out about robotic surgery. I already had my pre op appointment with my surgeon. I assume it's a regular surgery. I had a call in Thursday to ask how my knee was made. I wanted to know how they get the perfect measurements. The surgeon's nurse didn't call me back with an answer. My doctor also has done thousands of replacements. He has an excellent reputation. However, I feel stupid for not knowing what questions to ask until into late. I also am trying to read everything on this forum and I am somewhat mixed up with who us answering whom.

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@cindymattern

I have heard a total knee is better than a partial knee replacement but I can't really answer to that. Mine was a total. I do have some days where it feels stiff most of the day and I take it easier on those days. I have mine in September 2022 and I can honestly say it gets better each month out for me. You're still early on and to be honest mine felt better after I was done with PT but it's necessary to build their strength and ROM. I don't do exercises like I did when I was in PT but I still try and do them. I'm not sedentary at all and very active. I ride my bike once a day for 15-20 minutes, walk lots and do lots of activity. I think that helps tremendously but I do get sore. The inflammation can continue for a while but I can't take Nsaids for that. I just use Tylenol Arthritis once or twice a day morning and evening. I also can use Voltaren creme topically for inflammation and that helps as well. Keep telling yourself it will get better but I know it is hard early on. I was 7 months yesterday. Looking forward to that one year mark.

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Thanks. Very helpful for me getting first TKR in a few days. Did you have help at home and how long do you think you need help? Thank you.

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