Robotic Knee Prosthesis Surgery

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Not sure if you need the total operation or the partial one

Send your knee X-ray or MRI and your specialist's notes on WhatsApp. An orthopaedic reviewer will tell you whether robotic assistance applies to your case, whether a total or partial replacement fits your knee, and roughly how long you would need to stay, at no cost and before you book anything.

What Makes a Knee Replacement Robotic

Robotic knee replacement is not a different operation from a conventional one. The surgeon removes the same worn bone, balances the same ligaments, and fits the same type of implant. What changes is how the cutting guides are positioned. A robotic system builds a three dimensional plan of your own knee, usually from a CT scan taken before surgery, and holds the surgeon to that plan while the bone is being prepared.

Two versions of the operation use this technology. A total knee replacement resurfaces the whole joint. A partial, or unicompartmental, replacement resurfaces only the section that has worn out, leaves healthy cartilage and both cruciate ligaments in place, and is a smaller operation altogether.

Robotic Total Knee Replacement

A total knee replacement is the operation most people mean when they say knee replacement. The ends of the thighbone and shinbone are resurfaced with metal components, and a plastic spacer sits between them to replace the worn cartilage. It suits a knee where arthritis has spread across more than one compartment, which is the case for most patients by the time they reach a surgeon.

Robotic Partial Knee Replacement

Only one part of the joint is resurfaced, almost always the inner, or medial, side. The incision is shorter, less bone is removed, and patients typically feel more like themselves in the early weeks. It only works when the rest of the joint is healthy and the ligaments are intact, which is a narrower group of patients than the total operation covers. Robotic guidance matters more here than in the total procedure, because a partial implant has less room for error, and older manual techniques for this operation carried a higher revision rate for exactly that reason.

The systems you may hear named

Several robotic platforms are in routine use for knee surgery worldwide, including MAKO, ROSA, VELYS, NAVIO and CORI, and private hospitals across Turkey have adopted one or more of these in recent years as part of the same broader shift. They differ in engineering detail, mostly around how the system tracks the bone and how much force it lets the surgeon apply outside the plan. Published accuracy figures across these platforms sit in a similar range, generally within one or two degrees of the intended cut. Biruni's programme uses a CT-based robotic arm system from this same generation of technology, and the brand itself matters less than how many cases the operating surgeon has done on it.

Total, Partial, or Not Yet

Two things decide which operation fits your knee, and whether surgery belongs on the table at all. How much of the joint has worn down, and whether your ligaments are still doing their job.

Replacement is usually considered once daily pain has not responded to weight management, physiotherapy, activity changes and, in many cases, an injection. Imaging that shows arthritis is not on its own a reason to operate. Surgeons operate on the person in front of them, weighing the scan alongside how they actually feel and function.

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Weight is worth naming directly. A 2025 meta-analysis of robotic total knee replacement found that patients with obesity accounted for every mechanical implant failure recorded across 5,155 procedures, even though overall outcomes for the group were good. That is a reason to have an honest conversation about weight before surgery, and that conversation always comes first. Inflammatory arthritis, active infection anywhere in the body, and pain that does not match what the imaging shows are the other situations where a surgeon is likely to pause and investigate further before agreeing to operate.

How the Plan Is Built and Followed in Theatre

Most of the important decisions are made before your knee is opened, and the sequence runs in five stages.

Scan and plan

A CT or MRI scan taken before surgery is turned into a three dimensional model of your knee. Your surgeon sets the implant size, position and rotation there.

Registration in theatre

Once the joint is opened, the system matches the plan to your actual bone surface using a handheld probe or optical markers. This confirms the plan fits the knee in front of the surgeon just as well as the one on the scan.

Ligament balance check

Before any bone is cut, the system measures how the ligaments tension the joint as it bends and straightens. Many surgeons now use this data to adjust the plan slightly to your own soft tissue, an approach called functional alignment, instead of fitting every patient to one fixed mechanical angle.

Guided bone preparation

The surgeon still holds and drives the cutting instrument. The system resists any movement outside the planned boundary, similar to the lane assist in a modern car nudging the wheel back if you drift. Nothing about the cut happens without the surgeon's hand on the tool.

Trial fit and final check

Trial components go in first. The system re-measures the ligament balance and range of motion with the trial in place, and the surgeon adjusts before the final implant is seated and cemented.

A knee replacement without robotic assistance follows the same five ideas, using paper templates and mechanical jigs instead of a screen and a tracked arm. Both routes are legitimate surgery, performed thousands of times a year with good results. What the robotic version adds is precision at each step, while keeping the same underlying plan.

What the Published Evidence Shows

A 2021 systematic review in Knee Surgery, Sports Traumatology and Arthroscopy pooled 16 studies comparing robotic arm assisted total knee replacement with the manual technique. Component positioning was more accurate with robotic assistance, by a mean of 1.31 degrees at the femur and 1.56 degrees at the tibia, with a narrower spread of results around that average. Knee Society Scores were also higher in the robotic group in the short to medium term. Complication rates, including infection and stiffness, did not differ between the two techniques.

A 2026 randomised trial of 200 patients using the VELYS robotic system reported a mean deviation from the planned leg alignment of 0.09 degrees, against 0.32 degrees for conventional surgery. Blood loss during the robotic procedure was lower too, at roughly 125 millilitres against 202 millilitres. The trade-off was time. The robotic operation took, on average, half an hour longer on the table.

Revision surgery is the number that matters most to a patient choosing between techniques, and it is the hardest to measure well, because implants are meant to last decades and most studies do not run that long. The best current estimate comes from a 2025 meta-analysis of 20 studies and 5,155 robotic total knee replacements performed under a functional alignment plan. Range of motion improved from a preoperative average of 119 degrees of flexion to 123 to 125 degrees after surgery. The pooled rate of early aseptic revision, meaning a repeat operation not caused by infection within the first two to three years, came out at 0.35 percent.

Partial knee replacement has its own, separate evidence base, and it has moved a long way since the manual version of this operation earned its old reputation for wearing out early. A 2026 review of robotic ligament guided partial knee replacement reported survivorship of 98.8 percent at 2.5 years, 97.0 percent at 5.7 years and 91.7 percent at 10 years, with patient satisfaction consistently above 90 percent. In a matched comparison against total knee replacement, the partial group needed fewer manipulations under anaesthesia for stiffness, none against six in the total group, and scored notably higher on the Forgotten Joint Score, a measure of how little the joint intrudes on daily life, at both two years and five years.

Taken as a whole, a 2026 narrative review covering both randomised and observational studies found that robotic and manual total knee replacement land on broadly similar patient reported outcomes over the medium term. Where robotic assistance showed the most consistent early edge was in how quickly patients regained balance and a natural walking pattern, and in how satisfied they felt with the joint in the first year. Neither technique has produced long term data proving one lasts longer than the other, and any page that claims otherwise is ahead of the evidence.

Where the Evidence Is More Cautious

Better alignment on an X-ray is not automatically the same thing as a knee that lasts longer, and the honest answer is that nobody has thirty year data on robotic implants yet, because the technology has not existed for thirty years. What follows is what the current evidence supports, based on how many years patients have been followed so far.

One more limit is worth stating plainly. Robotic guidance narrows how far a surgeon's plan can drift during the operation. It does not select the plan itself, and it cannot correct a poor decision about candidacy made before the patient ever reaches theatre. The tool is only as good as the judgement directing it.

From Your First Message to Surgery Day

Most international patients get in touch after a local surgeon has already suggested knee replacement, sometimes with a waiting list attached that stretches a year or more. Sending your imaging early is the single most useful thing you can do. A recent X-ray or MRI, standing if possible, plus notes on which treatments you have already tried, lets a reviewer say something specific about your case instead of something general about the operation.

Sending your imaging for a first opinion

A specialist looks at your imaging and history and tells you whether robotic assistance is likely to apply, and, more importantly, whether the total or the partial operation fits your knee. This step is free and does not commit you to anything.

Getting cleared for theatre once you land

Standard blood tests, an anaesthetic assessment, an ECG for most patients and current imaging if your last scan is more than a few months old. Anyone on blood thinning medication, or with diabetes, needs this reviewed early enough before surgery so doses can be adjusted safely.

Surgery day and the first 48 hours

The operation is done under spinal or general anaesthesia, chosen with the anaesthetist beforehand. Physiotherapy usually starts the same day or the next morning, with a walking frame or crutches. Pain relief follows a planned combination of medications given on a set schedule, which is what allows most patients to be up and moving so soon after major joint surgery.

A total knee replacement typically means three to five nights in hospital before discharge, in line with what most private hospitals treating international patients in Turkey report. A partial replacement is usually shorter by a night or two, reflecting the smaller operation. Your companion can normally stay with you in your hospital room for the admission, and this is worth confirming as part of your quote, since the exact arrangement varies by room type.

Recovery Week by Week, and Fitness to Fly

Most patients take their first supervised steps within hours of returning to the ward. By discharge, the physiotherapy goal is usually a knee that bends past 90 degrees, enough to manage a single stair with a rail, and a wound that is dry and settling.

The first two weeks are about swelling control and sticking closely to the exercises your physiotherapist sets. Weeks three to six are when most people notice the knee starting to feel like part of them again rather than a surgical site, walking distance grows, and most partial knee replacement patients are off crutches sooner than total replacement patients, often within two to three weeks against four to six. Driving typically returns around four to six weeks, once you are off strong pain medication and can perform an emergency stop safely, and your surgeon will want to check this in person before clearing you. Full recovery, meaning the knee no longer dominates your daily planning, generally takes three to six months, with steady improvement continuing for up to a year.

Fitness to fly is a separate question from fitness to walk. Long haul travel raises the risk of blood clots after any lower limb surgery, so surgeons generally want to see a healing wound, a knee moving well within its expected range, and enough time on your feet to be confident that clotting risk has settled. Around two weeks is a common guide for a straightforward total knee replacement, sometimes a little sooner after a partial one, but this is a clinical decision made specifically for you at your follow-up appointment. Compression stockings and regular movement during the flight itself are standard advice regardless of how many days have passed.

What Happens Once You Are Home

The relationship with the surgical team does not end at discharge. A written summary of the operation, the implant used, and the rehabilitation plan should travel home with you, in a form your local doctor or physiotherapist can read and act on without needing to contact anyone abroad first.

A short remote check-in, usually by video call or messaging, is normal at around two and six weeks to review how the wound and the range of motion are progressing. Local physiotherapy in your home country can usually continue the same protocol you started in Turkey. Share your operative notes with that physiotherapist, and the assessment does not need to start from scratch.

Complications after flying home are uncommon, but a page that pretends they never happen is not being straight with you. What matters is whether the hospital that operated stays reachable and whether a local doctor can pick up the file without delay, and that is a fair question worth asking before you book. Biruni's international patients team is staffed to communicate in several languages, and messages from patients already back home are a routine part of their work rather than an afterthought.

What Sets the Price of a Robotic Knee Replacement

Treat any fixed price offered before a specialist has reviewed your imaging with caution. For a robotic knee replacement, the figure moves with whether the operation is total or partial, whether one knee or both need replacing, the implant chosen, how many nights you stay in hospital, and whether the robotic platform fee is itemised separately or folded into the package.

A partial knee replacement is usually less expensive than a total one, reflecting a shorter operation and typically a shorter stay, though the difference is not as large as the difference in bone removed, because implant and theatre costs still make up most of the total. Ask what a quoted figure includes and excludes in writing. The surgery and implant, the hospital stay, airport transfers, interpreting and follow-up appointments are the items that most often appear in one clinic's quote and quietly disappear from another's. Some international insurance policies contribute towards treatment abroad, though most domestic policies in your home country will not.

Private orthopaedic treatment in Turkey is generally positioned below equivalent private care in Western Europe or North America, which is a large part of why patients travel for it, and Biruni's packages are built to keep the surgical team, the robotic platform and the follow-up care at the same standard regardless of where the patient has come from. An accurate figure for your case comes only after your imaging has been reviewed.

Questions Worth Asking Before You Decide

Getting the clinical decision right is only half of planning this trip. The practical side deserves the same directness.

Ask how many people can travel with you, since recovering from knee surgery alone in a foreign country is harder than it needs to be. A companion travelling with you can normally stay through your hospital admission, and it is worth confirming the room arrangement in writing before you travel. Ask which languages the international patients team covers, and whether a female physician can be requested if that matters to you. Ask about dietary needs during your stay and about prayer facilities, and ask what the invitation letter process for your visa looks like and how long it typically takes. None of these questions are awkward to ask, and a team that answers them clearly before you travel is telling you something useful about how they will treat you once you arrive.

Frequently Asked Questions

Written by the Biruni Hospital medical editorial team.
Reviewed by Dr Yunus Emre Yavuz, Orthopaedics.

Scientific References

1. Zhang J, Ndou WS, Ng N, Gaston P, Simpson PM, Macpherson GJ, et al. Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2021;30(8):2677-2695. doi:10.1007/s00167-021-06464-4
2. Giovanoulis V, Vasiliadis AV, Andriollo L, Gregori P, Dretakis K, Koutserimpas C, Lustig S. Functional alignment in robotic total knee arthroplasty provides favourable outcomes and minimal early revisions: a systematic review and meta-analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2025;34(9):3362-3376. doi:10.1002/ksa.70226
3. Jaiswal A, Jaiswal S, Nayak DK, Buddhist H, Chaudhary H, Ranjan A. Precision over pace: a comparative study of VELYS robotic-assisted versus conventional primary total knee arthroplasty, a prospective randomized study. Journal of Clinical Orthopaedics and Trauma. 2026;81:103594. doi:10.1016/j.jcot.2026.103594
4. Sedransk OB, White AE, Oji NM, Pearle AD. Robotic-assisted ligament-guided unicompartmental knee arthroplasty for medial compartment osteoarthritis, current concepts. Journal of ISAKOS. 2026;19:101142. doi:10.1016/j.jisako.2026.101142
5. Capitanu BS, Dragosloveanu S, Nedelea DG, Dragosloveanu CI, Cergan R, Scheau C. Robotic-assisted total knee arthroplasty, current evidence on PROMs, functional outcomes, neuromotor recovery, and complications, a narrative review. Medicina. 2026;62(6):1173. doi:10.3390/medicina62061173