Robotic-Assisted (muscle-sparing) Total Knee Replacement
Overview
Total knee replacement treats advanced knee arthritis by replacing the worn joint surfaces with artificial components. The aim is to reduce arthritic pain, improve alignment and restore reliable walking, stairs and daily function.
A/Prof Ernstbrunner performs total knee replacement with robotic assistance and a subvastus muscle-sparing approach. This combination is a key part of his knee replacement philosophy: precise, anatomy-based robotic planning together with an approach that works around the quadriceps rather than cutting through the quadriceps tendon or splitting the muscle.
The subvastus approach is important because the quadriceps is central to standing, walking, stair climbing and knee control. By preserving (muscle-sparing) the extensor mechanism and reducing muscle disruption, this approach may support less early pain, better early quadriceps activation and a faster early recovery compared with more traditional approaches. It is not suitable for every knee, but when appropriate it offers a genuinely muscle-sparing pathway through surgery.
Who may benefit from total knee replacement?
Patients may benefit when knee arthritis causes persistent pain, stiffness, swelling, night pain, walking limitation or reduced quality of life despite non-operative treatment. X-rays are used to assess arthritis pattern and severity.
What does the procedure involve?
The worn joint surfaces are prepared and replaced with metal and polyethylene components. Robotic assistance helps match bone preparation, implant position, alignment and soft-tissue balance to the patient’s individual anatomy.
The knee is accessed through a subvastus approach. Rather than splitting the quadriceps tendon or cutting through the vastus medialis muscle, the approach works underneath and around the muscle to reach the joint. The intention is to preserve muscle integrity while still allowing accurate implant positioning and knee balancing.
Recovery after total knee replacement
Recovery starts early with walking, swelling control and range of motion. The muscle-sparing subvastus approach may help early quadriceps function, comfort and knee control, which can make the first phase of recovery smoother for suitable patients.
Robotic assistance supports accurate implant positioning and knee balance, while rehabilitation rebuilds motion, strength and confidence. Function improves over weeks to months, and the knee can continue improving for a year or more.
Rehabilitation protocol
You will receive a total knee replacement rehabilitation protocol covering wound care, walking, motion, strengthening and return to activity.
FAQs
What is robotic-assisted knee replacement?
Robotic-assisted knee replacement uses patient-specific planning and robotic guidance to help execute bone preparation, implant positioning, alignment and knee balance accurately. It is designed to make the reconstruction more precise and tailored to the individual knee.
What is the subvastus approach?
The subvastus approach is a muscle-sparing approach to knee replacement. Instead of cutting through the quadriceps tendon or splitting the quadriceps muscle, the surgeon works underneath the vastus medialis muscle to access the knee. This helps preserve the extensor mechanism and may improve early comfort, quadriceps activation and recovery in suitable patients.
When can I walk after surgery?
Most patients begin walking with assistance soon after surgery.
How long is recovery?
Daily function improves over weeks, while strength and confidence continue improving over months.
Will I need physiotherapy?
Yes. Rehabilitation is important for motion, swelling control and strength.
Book or Refer Today
For knee arthritis, book a consultation to discuss robotic-assisted total knee replacement using a subvastus muscle-sparing approach.
Reconstructive Orthopaedics Melbourne (ROM)
We restore mobility, reduce pain, and improve quality of life — through reconstructive orthopaedic surgery driven by evidence and advanced biomechanics.