FREQUENTLY ASKED QUESTIONS

With robotic-assisted surgery, your surgeon receives help from a robot to precisely place your implant, which is essential for your new knee’s fit and function. It’s a bit like having another expert in the room.

Before your surgery, the robot uses data from x-rays to create a 3D model of your knee. This model allows your surgeon to accurately plan your surgery and the precise placement of your implant.

It’s important to understand that your surgeon stays in the room with you and makes every decision throughout your procedure. The robot assistant won’t do anything unless instructed by your surgeon.

During your procedure, the robot uses highly accurate sensors to provide your surgeon with up-to-date data, via an interactive screen about your knee.

This information, combined with your surgeon’s skill and the robot’s precise robotic arm, helps them position your implant based on your unique anatomy. The robot also allows the surgeon to test your implant’s position once it’s in place and enables them to adjust it if necessary for a precise fit.

You can read a comprehensive breakdown of what happens during the Procedure here.

Today, the name ROSA is mostly associated with orthopaedic surgery. However, the first ROSA was originally designed by Medtech to assist neurosurgeons in delicate brain surgeries on patients with Parkinson’s disease or epilepsy. Launched in 2008, ROSA was a great success and quickly gained market share by offering a solution particularly well adapted to the needs of neurosurgeons. Thanks to the robot, neurosurgeons could perform operations that were previously impossible, including cases of childhood epilepsy once deemed untreatable.

ROSA was soon exported worldwide and in 2013, ROSA’s application diversified to integrate the spine and central nervous system—the birth of ROSA Spine. This new application introduced new technologies, including a camera and navigation system, and the first surgery was performed in 2014.

From neurosurgery to orthopaedics

In 2016, convinced that ROSA’s potential could be expanded in the orthopaedic field, Zimmer Biomet acquired Medtech, creating Zimmer Biomet Robotics. This marked the beginning of a great collaboration between Zimmer CAS—our Canadian R&D responsible for the application and clinical development of ROSA—and Zimmer Biomet Robotics. Within just two years, they created ROSA Knee. In 2018, the first patient operation was completed in Australia; today, more than 100,000 patients worldwide have been operated on with ROSA.

Prepare yourself physically and mentally, sleep well, relax and try not to worry. Before surgery, you should remain active and ask your doctor about starting an exercise program.

Prepare yourself physically

During the check-up, your doctor may look at the medication you currently take and suggest you make changes to your diet or begin exercising.

Tell your doctor if you currently have dental work done. To prevent germs in your mouth from entering your bloodstream and causing an infection,
your doctor might ask you to stop or delay any dental works.

If you are a smoker, you should tell your doctor as smoking can delay your recovery.

One of the decisions prior to knee replacement surgery is what type of anaesthesia will be administered. Before your surgery is scheduled, your anaesthesiologist will review your past medical history, give you an exam and then discuss the type of anaesthesia recommended for you. Ultimately, the final decision is made jointly between you and your anaesthesiologist.

General anaesthesia involves a complete loss of consciousness, while local anaesthesia numbs a specific area of the body without altering brain or
breathing functions. Occasionally, the anaesthesiologist will strongly recommend one over the other because of your current medical condition or because of the type of procedure.

Your care team will give you some suggestions and guidance about how best to arrange your home for your recovery. There are many things you can do to aid your independence. Some useful ideas are listed below:

• Arrange furniture so it’s easier to get around your home.
• Remove trip hazards to prevent falls.
• Note any uneven floors and steps.
• Raise your bed or rent a hospital bed, so it’s not too low.
• Choose high-armed chairs with firm seats.
• Keep things in easy reach particularly items you use often.
• Be aware of areas that get wet and put non-slip mats down.
• Use a raised toilet seat to make sitting and standing easier.
• Install railings where you might need more support.
• Dressing sticks, sock aids and tight aids.
• Long shoehorn, to aid you putting on and taking off your shoes.
• Shopping trolley, to ensure that you aren’t over-loaded and can focus on your footing.
• Wear clothes and shoes that you can take on and off easily. Ideally shoes should be slip-on or fastened with velcro.
• Restrict pets to their own area of the house, so they don’t cause you to trip.

We would recommend taking the following items with you before your surgery:

• Pyjamas or nightgownand dressing gown.
• Toiletries (toothbrush,soap, brush etc).
• Tracksuit with a wide-cut entrance for your foot.
• Flat shoes (not sandals) with non-slip soles.
• Shoehorn with a long handle.
• Backpack or fabric bag with long handles.
• Support-providing trainers, ideally fastened with Velcro.

Your initial preparation, surgery time, and time spent in the recovery area, should take around four hours.

Immediately After Sugery

You’ll be moved to the recovery room where you’ll be monitored by specialised nurses. They’ll look after you while you’re unconscious, and ensure a good recovery from the anaesthetic, before you can be transferred to a regular ward.

For the first few days, your knee will be swollen and tender; all of this is normal.

Your first movement and steps

After your operation, the hospital team will help you to get out of the bed as soon as possible, so you can start walking, sitting and going to the bathroom with walking aids. Most patients will be able to walk on the same day of surgery. This early movement promotes good circulation and movement of your knee and reminds you that you are not sick.

Walking again

To get you back on your feet after surgery, you’ll learn to walk with walking aids first and then with crutches.

Typically, you’ll use the crutches to walk on both legs. Your healthcare team will let you know when you’re safe only to use one crutch or stop using them altogether.

Your pain control

Good pain control will allow you to sleep better, helping your body heal more quickly and enabling you to leave hospital sooner.

Our pain perception is very different from one person to the other, so if you have pain, don’t hesitate to ask your medical team, they are there to help you and would not want you to be uncomfortable.

You’ll typically be in the hospital for 1-3 days, and before you’re allowed home, you’ll need to accomplish discharge goals like:

• Getting in and out of bed by yourself.
• Having an manageable amount of pain.
• Being able to eat, drink, and use the bathroom.
• Being able to perform the prescribed home exercises.
• Walking with an assistive device  (walker, or crutches) on a level surface and being able to climb up and down a required number of stairs.

Your recovery

Because everyone is different, the time it takes you to recover will be unique. You’ll go through all the usual stages of rehabilitation, but you could reach some goals sooner or later than described.

Your care team understands that your body is unique, and they’ll be aware of how best to keep you safe during and after surgery. However, it is always good to be aware of any possible side effects and if at all concerned discuss with your surgeon.

Normal effects after your surgery:

As part of the usual healing process, you’ll probably experience the following:

A certain amount of pain
Any pain you experience will be at its worst for the first 24 hours after your surgery, and then it should begin to ease. Your care team will manage your pain with medication.

Swelling and bruising
For several weeks after your surgery, the area around your new knee might be swollen, but this will reduce.

Feeling numb
You will likely experience some numbness around the surgery site for the first few weeks after surgery, but this should go away over time.

Like with any surgery, joint replacement can have some risks. To fully understand potential risks and how your care team will help you minimise them, please speak to your surgeon.

The following are some suggestions that might make life a little easier once you’re back at home.

• Ask someone to help with your house work for a while.
• Follow your doctor’s advice about painkillers.
• You might feel more tired than normal, so plan rests for mid-morning and mid-afternoon.
• Ensure that you do not change your sleep pattern and try to get a good night’s sleep.
• You’ll have swelling around the knee joint, so you might find baggy clothes more comfortable.

It is not uncommon to get a slight increase in pain around 6-12 weeks after surgery.

This is usually as a result of increased confidence and therefore increased activity. If you experience an increase in pain, make sure you allow enough time for rest after activity.

Be patient with yourself.

You should aim to gradually increase your walking distance and the amount of activity that you do every day.

It is important for the long-term success of your new joint that you continue your exercises.

Which and when you can take up sports again after your surgery will depend on a number of factors. For example how active you were before and how your recovery is progressing. Speak to your care team about what`s best for you.

Please make sure to discuss with your healthcare professional first before beginning any physical exercise.

After your surgery, the goal is to be as active as possible and to slowly perform all the tasks of daily life using your operated knee as naturally and as much as possible.

Using walking aids
Keep your feet straight and shoulderwidth apart, and place the two aids in front and slightly to the side of your feet. Bend your elbows and put your weight on the handles, supporting your body weight with your hands.

Sitting down or getting up
It’s best to sit straight on a high chair with armrests. When you get up, try to do his as normally as possible; slide forward and support yourself on the armrests.

Climbing stairs with walking aids
If the stairs have bannisters, use only one walking aid. Put your healthy leg on the higher step and use the walking aid to support your operated leg, place your free hand onto the bannister. Support yourself with the banister and walking aid and now put your operated leg onto the same step and when and you feel confident and without pain move on to the next step – repeat to climb the stairs.

Walking downstairs
Initially this is not as easy as going upstairs, but try not to worry if you find this difficult. Place both walking aids on the next lower step, then move the operated leg to that step while supporting your weight on the walking aids. Then move the healthy leg to the same step and when you feel confident and without pain repeat the process to descend the stairs.

Taking a shower
Wear non-slip shoes and always get into and out of the shower with your healthy leg first. Consider adding aids to the shower to make it safer, such as a non-slip mat, secure shower stool with four legs and a sponge with a long handle.

Taking a bath
Only take a bath when you feel safe to do so and when the scar is perfectly healed. Place a secure square stool that’s slightly higher than the bath’s edge next to the bath. Always lift your healthy leg into the bath first, and use your hands to support the weight of your operated leg. Aids such as a bathtub seat, non-slip mat and handles might make bathing easier.

Putting on shoes
Wear flat, stable, lace-less shoes that you can put on without leaning forward. Use a shoehorn with an extra-long handle to put shoes on and take them off.

Getting dressed
Early in your recovery, it’s best to have someone help you get dressed or use a dressing stick and sock aids. Use the stick to grasp a garment’s waistband and pull it over your operated leg. Then use the walking aid to get up and pull the garment up. When undressing, always unclothe your healthy leg first.

Getting into bed and sleeping
Remain straight and tilt your upper body backwards slightly, then lift your healthy leg into bed followed by your operated leg. You should sleep on your back with your legs spread slightly, but if you’re a side-sleeper, keep a pillow between your legs so you can’t cross them.

Getting out of bed
Place your buttocks on the edge of the bed, then lift your operated leg followed by your healthy leg out of bed. Your bed should be stable and about 70cm tall – if it’s too low, put a second, harder mattress in the bed or raise the bed frame.

Getting into a car
Get into the car on whichever side gives you more legroom. Turn your back to the seat, sit down and lift your legs into the car, supporting your thighs with your hands. Be sure to move slowly. To get out of the car, do the same in reverse.

Sexual activity
For the first six to twelve weeks after surgery, don’t put too much stress on the knee joint and avoid excessively rotating or bending the knee.