GP Talking to Patient About Knee Surgery

You’re considering private knee surgery to address your knee pain, but with knee surgeon, implant and (potentially) robot all playing a part in your decision, where should your focus be? Jim Newman shares his view.

Not long ago, the Yorkshire Knee Clinic’s take on the current state of robot-assisted knee surgery shifted. You can read the full piece here, but essentially our position boils down to this: it is entirely possible to achieve excellent results using robot-assisted surgery, but that’s not the same as saying excellent results were achieved because a robot played a part.

As my colleague Nick London said at the time, “We may reach a point where there is clear evidence of clinical benefit over risk for low volume and perhaps even high-volume surgeons,” but we’re not there yet.

My personal view on this is to stress that word ‘yet’. I wouldn’t currently recommend basing your choice of knee surgeon on the type of robot they happen to work with, because the experience of the surgeon, the volume of procedures they carry out, and the proven quality of the implant are currently the factors that really affect the success of your knee surgery.

For the next generation of robots (or the generation after that), though, who knows? Tech always improves. There may well come a point where robot-assisted knee surgery becomes the gold standard. Every surgeon already uses technology to help them in their roles to varying degrees. Sooner or later, I imagine we will see the results of the large, randomised control trial that demonstrates robot assistance has crossed the threshold to being entirely normal, accepted and even preferred.

But what about the now?

Right now, the crucial elements in the success of your knee replacement are the surgeon and the implant.

> Discover more about partial or total knee replacements


Why knee surgeon experience matters

We’ve spoken before about the importance of choosing a knee surgeon who performs lots of knee replacements over one who doesn’t.

For example, over the past three years, the cumulative average number of partial knee replacements carried out by surgeons in England and Wales was 41. That’s barely more than one a month. For the surgeons of Yorkshire Knee Clinic, things are vastly different. You can discover how different here. And that is, of course, an average, heavily influenced by those of us who do lots of partial knee replacements. Not long ago, research showed that the most common number of partial knee replacements carried out by surgeons each year was just one.

There’s a simple way to check the volume of operations performed by your knee surgeon: the National Joint Registry keeps an independent record. You can find my National Joint Registry data here, for example.


Why implant rating matters

Like any product you buy, there’s a rating system for implants. Unlike most products, however, the rating really matters, because if your implant turns out to be faulty, it’s not as though you can easily take it back to the shop for a replacement.

The people who control implant ratings are ODEP (the Orthopaedic Data Evaluation Panel). Their rating consists of:

  • A number, which represents the number of years for which there’s evidence to support the product
  • A letter, which represents the strength of supporting evidence
  • A star, the presence of which indicates a replacement rate of less than 1 in 20 at ten years

The Persona Partial Knee, for example, is an implant we commonly use for our partial knee replacements. It has a rating of 5A* which means that:

  • The implant has five years of evidence to support it
  • The evidence is high quality
  • The replacement rate is very low


Private knee surgery: what matters?

Right now, surgeon volume and implant matter more than the presence, absence or model of robot. That may not always be the case, but if you need a knee replacement now, I’d suggest it’s the best route to a successful operation.

To explore options for your knee replacement, please contact us, or phone us on 03453 052 579.

> Find out more about Jim Newman
> Questions about your knee surgery?
> Discover more about partial or total knee replacements

James Newman

James Newman

Private appointments weekly at Spire Methley Park Hospital

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Spire Methley Park
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