Robotic total knee replacement: First of its kind experience at Kauvery hospital, cantonment, Trichy

Robotic total knee replacement: First of its kind experience at Kauvery hospital, Cantonment, Trichy – 2025

Reeni ¹, Subathra Devi. M², Maha Lakshmi ^3*

¹Operation Theatre Incharge, Kauvery hospital, Cantonment, Tamil Nadu

²Nurse Educator, Kauvery hospital, Cantonment, Tamil Nadu

³Nursing Superintendent, Kauvery hospital, Cantonment, Tamil Nadu

*Correspondence

Abstract

The introduction of robotic-assisted Total Knee Replacement (TKR) at Kauvery Hospital, Trichy Cantonment Unit underscores the institution’s strong commitment to innovation, patient safety, and excellence in orthopedic care. This milestone marks the first robotic-assisted TKR performed at the center, setting a new benchmark for knee replacement surgery in the region. This article describes the introduction, execution, and early outcomes of robotic-assisted TKR. The patient underwent surgery using an advanced pre-operative planning system that enabled precise assessment of bone anatomy, soft tissue balance, and implant alignment. intra-operative robotic assistance facilitated accurate bone cuts and optimal implant positioning, thereby enhancing surgical precision and consistency. Early outcomes demonstrated improved alignment accuracy, preservation of soft tissues, reduced post-operative pain, and faster functional recovery. The successful implementation of robotic TKR highlights the importance of multidisciplinary coordination, adherence to standardized protocols, and effective use of advanced technology in achieving superior patient outcomes. Overall, robotic-assisted TKR represents a significant advancement in joint replacement surgery at Kauvery Hospital, offering improved surgical accuracy, enhanced patient safety, and promising

Key words: Total Knee Replacement (TKR); 3D mapping technology; Robotic arms

Introduction

Robotic TKR has redefined joint care by offering precision and superior implant alignment. However, the integration of robotic arms and 3D mapping technology into high volume schedules introduces technical complexity and potential workflow delays. Following the launch of the Kauvery Hospital of Robotic Surgery, the Cantonment branch implemented specialized management protocols to ensure that robotic cases often perceived as time-intensive were executed with the same efficiency as conventional procedures.

Advantages of Robotic TKR

High precision and accuracy

Robotic systems enable highly accurate bone cuts and optimal implant positioning based on the patient’s individual anatomy, reducing alignment errors.

Personalized surgical planning

Pre-operative planning using imaging allows customization of the procedure, ensuring better joint balance and implant fit.

Improved soft tissue protection

Robotic assistance helps preserve surrounding ligaments and soft tissues, leading to more natural knee movement post-surgery.

Reduced post-operative pain

Minimally invasive and precise surgical techniques result in less tissue trauma and reduced pain after surgery.

Faster recovery and rehabilitation

Patients often experience quicker mobilization, shorter hospital stays, and faster return to daily activities.

Enhanced implant longevity

Accurate alignment and placement reduce wear and tear, potentially increasing the lifespan of the knee implant.

Consistent and reproducible outcomes

Robotic guidance minimizes variability between surgeries, ensuring standardized and reliable surgical results.

Better patient satisfaction

Improved functional outcomes, stability, and comfort contribute to higher patient satisfaction rates.

Role of surgeon and staff in surgical process

Pre-operative responsibilities

Verify patient identity, consent, and surgical site marking.
Ensure completion of pre-operative investigations and bowel/bladder preparation as per protocol.
Educate the patient about robotic procedure, positioning, and post-operative expectations.
Prepare and check robotic system availability, accessories, and sterile disposables.
Ensure implant availability and compatibility with the robotic plan.
Perform surgical safety checklist and time-out procedures.

Intra-operative responsibilities

Assist in patient positioning and padding to prevent pressure injuries.
Maintain strict aseptic technique throughout the procedure.
Assist the surgeon during registration, calibration, and robotic arm docking.
Monitor robotic equipment function and coordinate with biomedical support if required.
Handle instruments, implants, and robotic accessories accurately.
Anticipate surgical needs and ensure smooth workflow within the operating room.

Patient safety and monitoring

Monitor vital signs in coordination with the anesthesia team.
Observe for signs of nerve injury, bleeding, or positioning-related complications.
Ensure radiation safety (if imaging is used) and electrical safety compliance.

Post-operative responsibilities

Assist in safe transfer of the patient to the recovery area.
Monitor for immediate post-operative complications such as bleeding, pain, or neurovascular deficits.
Ensure documentation of implants, robotic data, and surgical notes.
Educate the patient on wound care, pain management, mobilization, and physiotherapy protocols.

Equipment and documentation responsibilities

Ensure proper cleaning, handling, and storage of robotic instruments.
Coordinate sterilization and maintenance of robotic equipment.
Maintain accurate records of consumables, implants, and robotic usage.
Report incidents or equipment malfunctions through hospital safety systems.

Team coordination and quality improvement

Act as a liaison between surgeons, anesthetists, physiotherapists, and ward staff.
Participate in audits, training, and competency programs related to robotic surgery.
Contribute to continuous improvement, patient safety initiatives, and protocol development.

Surgical outcomes

Fig (1): Pre-operation

Fig (2): Post-operation

Conclusion

The 2026 Robotic Total Knee Replacement (TKR) represents a significant advancement in orthopedic surgery by enhancing precision, personalization, and patient safety. Through accurate implant positioning, improved soft-tissue protection, and consistent surgical outcomes, robotic assistance contributes to reduced post-operative pain, faster rehabilitation, and improved long-term implant longevity. Effective coordination among the surgical team, strict adherence to pre, intra, and post-operative responsibilities, and meticulous equipment handling and documentation are essential for successful outcomes. Continuous training, quality improvement initiatives, and multidisciplinary collaboration further strengthen patient safety and surgical excellence. Overall, robotic TKR supports better functional recovery, higher patient satisfaction, and consistent, reproducible results, making it a valuable approach in modern joint replacement surgery.

Robotic total knee replacement: First of its kind experience at Kauvery hospital, cantonment, Trichy – 2025