Total Knee Replacement (TKR) surgeries have come a long way since its initiation to 1980. A lot of improvements in SURGICAL MATERIALS, EQUIPMENT and TECHNIQUES have greatly increased the effectiveness of this procedure. To overcome the challenges of accurate implant positioning and alignment, there was a continuous need of innovation. Computer assisted surgeries started a new phase of this innovation. And if we are to talk about recent trends and breakthrough technologies, RATKA (Robotic Assisted Total Knee Arthroplasty) should lead the way for present as well as future.

Conventional TKA

◐  Up to 20% of patients remaining dissatisfied following TKA.
◐  Human controlled variables affecting outcome in TKA

  •  Accurate implant positioning
  •  Balanced flexion-extension gaps
  •  Proper ligament tensioning
  • Preservation of periarticular soft-tissue envelope

◐  Conventional jig-based TKA uses preoperative radiographic films, intra-operative anatomical landmarks, and manually positioned alignment jigs to guide bone resection and implant positioning.

◐  Conventional jig-based TKA is associated with poor reproducibility of alignment-guide positioning, inadvertent saw blade injury to the periarticular soft-tissue envelope, and limited intra-operative data on gap measurements or ligamentous tensioning to fine tune the implant positioning.

◐  Suboptimal implant positioning may lead to

  •  Poor functional recovery
  •  Reduced clinical outcomes
  •  Increased instability
  • Reduced implant survivorship

Navigated TKA

◐ In navigated TKR, computer software converts anatomical information obtained from intra-operative osseous mapping into a virtual patient-specific 3D model of the knee joint.

◐ Virtual model is used to plan optimal bone resection, implant positioning, bone coverage, and limb alignment based on the patient’s unique anatomy.

◐ Computer navigated TKA provides patient-specific anatomical data with recommendations for bone resection and optimal component positioning.

Robotic Joint Replacement

CUVIS joint, “A fully automatic joint replacement surgery Robot”, is the most advanced fully and active robotic joint replacement surgery system available at BIMS hospital, Bhavnagar, Gujrat.

Introduction: Joint Replacement Surgery & technology

One of the frequently performed surgical procedure in recent times is knee replacement. The damaged knee surface known as cartilage is removed during a knee replacement and replaced with an implant. Whole/Total knee replacement, partial knee replacement, and revision knee replacement surgery are the three main types of knee replacement procedures.

With the development of technology, robotic assistance is now used during knee replacement surgery. More accuracy, enhanced safety, a reduced chance of postoperative complications and blood loss, and a quicker recovery period with effective physical therapy are all benefits of robotic knee replacement surgery.

The outcome of any surgery depends on the precision with which the surgery is carried out. This is true more in Joint Replacement Surgery. A well-performed TKR gives better results and lasts longer, and patient satisfaction is higher.

A well-performed TKR is all about ligament balancing and getting proper joint alignment through deformity correction as on the brink of natural as possible. Ligament balancing means both, the inner as well as outer, compartments of replaced knee undergo the same amount of stress throughout the range of motion. A well-aligned knee is where the deformity which patient had previously due to his/her arthritic knee is corrected while taking bone cuts and joint alignment is achieved to give the patient a sense of natural knee.

All this will be achieved with the assistance of technology in Joint replacement latest being Robotic joint replacement surgery. The advantage of robotics in joint replacement surgery is that it does not require pre-operative investigations like CT Scan and all data is provided to the computer at the time of surgery and necessary changes are often made accordingly. This also helps to avoid surprises during surgery. Robotic surgery provides the most important aspect, that is, precision to the surgery which is essential for successful outcome and longevity of the implant.

The implants used in the joint replacement are subjected to wear over a period of time. Studies have shown better aligned and well-balanced implants have less wear and longer life. Also nowadays, degenerative arthritic changes are seen in younger age group patients. In such patients, longer lifetime of implants is important due to the longer anticipation. Robotic joint replacement surgery provides the fundamental aspects of well-aligned and balanced knees, decreasing the wear and providing longer life to implants.

Robots for Knee Replacement

Depending upon the execution and working methodology during surgery, there are different types of robots available for knee replacement:

Passive Robot: These are mostly imageless or x-Ray-based systems. They do the job of knee navigation and do not assist surgeon to make cuts, as the robotic arm is not capable of taking bone cuts.

Semi-Active Robot: CT image-based systems with a hepatic arm and surgeon has to guide the arm to the bone and take bone cuts. Again, it has certain limitations, some of the important intra-operative procedures like box cut, lug holes, re-cuts and some other manipulations are difficult to handle.

Active Robot: CT image-based system (CUVIS Joint) and does accurate pre-plan and one cannot err on important surgical landmarks. Does help surgeons to take all the cuts in their preferred sequence and also, it’s all automatic- surgeon uses a remote control to manoeuvre the robotic arm and the cutting tool makes all cuts with utmost precision and safety.

How Does a Fully Active Joint Replacement Robot Work?

  • Once the patient decides on the Robotic Surgery, the doctors perform the CT Scan of the patient’s knee.
  • The robot converts the CT image into a 3D model of the patient’s knee for doctors to diagnose the condition and pre-plan the surgery, as required.
  • The patient is connected to the robot and stabilized for surgery.
  • The doctors perform the registration process to verify if the 3D image of the patient matches the original surgery site.
  • After the registration process, the robot reviews the data and cuts the bone precisely with respect to the size, position, angle and direction of the implant decided during the pre-surgery planning stage, preserving the cruciate (Ligament).

What is Robotic Knee Replacement? How does it Work?

The robotics-enabled artificial intelligence helps achieve more precision and accuracy ensuring a well-balanced knee. It takes help of CT-Scan images to develop patient specific 3D bone models virtually. Thus, if you see, in robotics method the SURGERY TAKES PLACE 2 TIMESfirst time on laptop where the doctor plans the surgery with the help of CT-Scan images and the in the OT with the robot. The doctor feeds in the plan of the surgery in the robot and with utmost precision the robot takes all the bone cuts avoiding any complications. It is often seen that; patients visit a hospital when the problem or pain has aggravated to an advanced osteoarthritis level. In such patients even 2 sub-millimetre of precision is of utmost importance. Which can be achieved by robotic surgery.

Benefits of Robotic Knee Replacement?

  • Best technology + technique accepted worldwide.
  • Less Surgical Time
  • Ensures faster Recovery.
  • Surgical Accuracy
  • Consistent Results
  • Faster Recovery
  • 3D personalised surgical pre-planning using high-end CT scan-imaging.
  • Sub-millimetre accuracy during the operation
  • Gives the feeling of a natural knee.
  • Less bone loss, ligament loss and blood loss
  • Best implant positioning with a maximum cutting accuracy
  • Real-time monitoring
  • Chances of infection reduced due to minimal human intervention.

What is the difference between traditional Knee Replacement Surgery & Robotic Knee Replacement Surgery?

In conventional technique the surgeon performs the whole procedure himself without any computer or robot intervention. Whereas when compared to robotic surgery, the surgeon and robot work as team to perform the surgery. It is often seen that; patients visit a hospital when the problem or pain has aggravated to an advanced osteoarthritis level. In such patients even 2 sub-millimetre of precision is of utmost importance. Which can be achieved by robotic surgery.

Why To Choose Robotic Knee Replacement

With the increasing cases of Arthritis, Rheumatoid, and Osteoarthritis, knee pain leading to knee replacement surgeries is at a rise. In a scenario like this, a breakthrough technology is an all-time boon that can help surgeons perform the surgery without the scope of manual or miscalculated error and help patients get the best of outcomes. To address the requirements of both patients and surgeons, CUVIS Robot, Bhavnagar’s first fully active robot for knee replacement surgery is here at BIMS Super speciality Hospital, Bhavnagar.

  • More accurate Implant placement
  • Reduced risk of injury to soft tissues
  • Quicker recovery & less pain
  • Less blood loss
  • Long life of Implants

What Is CUVIS Joint Robot System?

CUVIS Joint Robot System is the most advanced surgical cutting edge robotic technology supporting surgeons with Personalized Preplanning and Precise Cutting for predictable and consistent results. It is made up of three key components: the Main Console, the Robotic Arm, and the Planning Device. The Main Console with Optical Tracking System (OTS) aids in real-time monitoring and directs the surgeon through the procedure. The majority of the bone cutting is done by a robotic arm with a milling tool positioned on its tip.

  •  The Role of Fully Active Robot in Knee Surgery

The CUVIS Joint Robot creates a 3D model of the patient’s knee, which the surgeon utilizes as a guide to make correct bone incisions and precisely place the knee components.

Personalized pre-planning: The doctor uses 3D pictures of the patient’s joints to arrange the operation specifically for each patient.

Pre-selection and exact insertion of artificial joint: The doctor utilizes the robot to choose and precisely install an artificial joint for the patient.

Precise cutting for accuracy and optimum alignment: The robot analyses the data and accurately slices the bone in relation to the dimensions of the pre-selected implant.

Advantages of CUVIS for Artificial Joint Surgery


  • Improved workspace check.
  • 3D bone model generation with fast and easy CT image data.
  • Ul design considering user convenience.


  • Precise pre-surgical planning is executed every time.
  • Sub-millimetre dimensional accuracy.
  • Optimal alignment.


  • Various cutting options – Full & partial cutting.
  • Intra-operative gap check – Pre/Intra/Post.
  • Plan changing & gap balancing possible.


  • Real-time system monitoring.
  • Emergency stop & force freeze.
  • Manual guide of robot arm.


CUVIS JOINT is completely independent, whereas the other robots work as a helping hand. The robotic technologies present at the moment can be categorized as passive or semi-active devices but CUVIS Joint is a fully active robot. The others do have a robotic arm but is passive, the surgeon holds the same and performs the cutting of bone area.

BIMS Super speciality Hospital has always strived to serve patients with superior care supported by up-to-the-minute technology. CUVIS Joint Robot System is a step towards our mission. With this next level of technology, we seek to empower our surgeons and benefit our patients at the same time. In turn, bringing the change in the face of joint replacement surgeries. Make an appointment to learn more.


Why is Golden Knee Replacement Better?

Regular knee implants, made of chromium or cobalt tend to release metal ions in the body. In patients who have metal allergy, these metal ions can cause inflammation in the knee area and eventually cause complications like infection, pus formation and severe knee pain. Hence, for such patients, a Golden Knee Surgery is generally suggested. The implant used for this surgery has a GOLD coloured Titanium-Nitride/Zirconium nitride coating. Not only does the golden knee implant prevents any allergic reaction with the body, but also, is more durable and has a longer life.

Who should undergo Golden Knee Replacement?

Even though any patient who is a candidate can opt for Golden knee replacement. It is preferably advisable for patient who have any kind of metal allergy.

Is it favourable to undergo both knee joint replacement surgery in one sitting?

Literature says that undergoing bilateral knee replacement surgery increases the risk of thrombosis and chances of morbidity is high. Although if a person is medical fit, then undergoing bilateral knee replacement surgery has its own benefits, like less hospitalization, single anaesthesia, simultaneous physiotherapy for both knees & reduced medication.

Is knee replacement procedure safe? Can it be avoided?

Yes, the knee replacement procedure is completely safe and can be considered as one of the most common surgeries now-a-days. It is recommended in severe cases of arthritis to reduce pain and have better quality life or an active lifestyle. The doctor recommends it only when all other therapy options like medications, walking support, etc. are of no use and can’t help with the symptoms.

Is robotic surgery really better than conventional manual knee replacement surgery?

When compared to conventional manual knee replacement surgeries, robotic knee replacement has got a lot of advantages in terms of better implant positioning, precise surgical bone cuts, least human intervention, faster recovery and least hospital stay. Considering its minimally invasive nature, it causes lesser tissue trauma and thus less blood loss and faster recovery.

Is there any risk associated with robotic knee replacement surgery?

Advanced robot like CUVIS Joint have best in class safety features and do not cause any additional risk to patients undergoing knee replacement surgeries. With advanced features like Bone Movement Monitoring and Haptic Feedback mechanism, it monitors everything in real time. Thus, it delivers best surgical outcome with maximum safety to the patients.

Are all the robots for knee replacement same?

Even though robotic technology for knee replacement is the most advanced therapy option in today’s scenario, there are different types of robots available in market. Amongst all, CUVIS Joint is the only robot which is autonomous in complete sense. Other options of robot just act as a guiding system for surgeon and thus possess the risk of intra-operative human errors. These systems are called as passive or semi-active, whereas CUVIS Joint is of active nature.

how long do I need to stay in hospital for the robotic TKR surgery?

Minimum 3 to 6 days after operation

Will I be able to walk and do regular day-to-day activities independently post knee replacement surgery?

Yes, once initial recovery is done, one can start walking a bit in a week’s time itself. Post 2-3 months of recovery, you’ll be able to do the maximum of day-to-day activities. And a myth buster, apart from an initial period of recovery, one does not need any walking support post knee replacement surgery.

Top Robotic Surgeon in Bhavnagar

Dr. Sanjiv Ravisaheb Orthopedic/ Trauma Bhavnagar
Dr. Sanjiv Ravisaheb
Top Robotic Surgeon

Robotic Surgery