Webinar: Knee Osteoarthritis and the Benefits of Robotic Knee Replacement

Webinar | Knee Osteoarthritis and the Benefits of Robotic Knee Replacement with Mr Tofunmi Oni

00:00 – Introduction

Hello everyone. Welcome to our Knee Osteoarthritis Webinar.

My name is Josephine and I'm Head of Marketing and Sales, and we are delighted to introduce Mr Tofunmi Oni, who is one of our Consultant Orthopaedic Surgeons here at The Horder Centre. He completed specialist training in Kent, Surrey, and Sussex before advancing his expertise in hip and knee joint surgery through a fellowship in Sydney, Australia, where he gained extensive experience in complex and computer assisted surgical techniques.

We will take a closer look at understanding knee osteoarthritis, how it affects you, and the treatment options available, including the latest in robotic surgery.

Before I hand over to Mr Oni, please can I remind you that this is a live recorded event. Your cameras and microphones are turned off, and if you have not done so already, you can change your name to anonymous or a pseudonym by following the instructions we sent earlier today.

Please note we cannot respond to raised hands during the session. If you have questions, type them in the Q&A section. You will see an icon at the top of the page, and we will address them at the end. We will also try to cover questions submitted during your application.

Once again, thank you for joining us, and please welcome Mr Oni. I like to call him Tofi.

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01:30 – Speaker Introduction and Overview

Thank you very much.

Hello everyone. Welcome along today to this webinar. I am Tofunmi Oni, most people call me Tofi, and I hope everyone can hear and see me.

Today we are going to talk about knee osteoarthritis, what it is, how it develops, and the management options available. Towards the end, we will also discuss robotic surgery, which is an area of particular interest to me.

So let us begin.

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02:20 – What is Osteoarthritis

Osteoarthritis, in simple terms, is the gradual deterioration of a joint, specifically the articular cartilage. This cartilage sits at the ends of bones and helps keep the joint surfaces apart.

On an X ray, a normal joint shows space between the bones, representing healthy cartilage. In osteoarthritis, that space narrows or disappears.

As cartilage is lost, the underlying bone takes more load and changes. The lining of the joint, known as the synovial membrane, becomes inflamed. This inflammation releases substances that further damage cartilage, creating a cycle that worsens over time.

Patients typically experience joint pain, stiffness, reduced mobility, difficulty with daily activities, and sometimes disturbed sleep.

Osteoarthritis is extremely common and is the leading cause of disability among adults. While it is often associated with ageing, it can also result from injury or inflammatory conditions.

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05:30 – Diagnosis and Spectrum

In terms of diagnosis, we follow a straightforward clinical approach.

Age increases the likelihood of osteoarthritis. Symptoms usually include pain, stiffness, and sometimes instability. The location of pain is also important. Most people experience pain on the inner side of the knee, where the majority of weight is carried.

Osteoarthritis exists on a spectrum. Some people have it without symptoms, while others are significantly affected. Treatment decisions are based on how much it impacts quality of life.

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07:20 – Conservative Management

The first stage of treatment is conservative management.

This includes lifestyle changes such as weight loss, which can significantly reduce stress on the knee.

Low impact exercise is recommended, including swimming, cycling, and rowing.

Physiotherapy helps strengthen the muscles around the knee, improving support and reducing stiffness.

Pain relief medication may also be used.

These approaches can often manage symptoms effectively without further intervention.

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08:40 – Injection Treatments

If symptoms persist, injections may be considered.

These include steroid injections, hyaluronic acid injections, and platelet rich plasma.

They aim to reduce inflammation and improve joint function but tend to provide only short term relief.

A newer option is Arthrosamid, a hydrogel injection. It integrates into the lining of the joint, reduces inflammation, and provides cushioning. It is not reabsorbed and becomes incorporated into the body over time. Current evidence suggests it may provide benefits for up to five years.

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11:20 – Arthroscopy and Osteotomy

Arthroscopy, or keyhole surgery, has limited benefit for osteoarthritis itself, as it does not restore lost cartilage. However, it can help if there are meniscal tears causing mechanical symptoms such as clicking, locking, or the knee giving way.

For younger patients, an osteotomy may be considered. This involves cutting and realigning the bone to shift weight away from the damaged area.

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13:00 – Knee Replacement Surgery

Knee replacement surgery is the most common surgical treatment for severe osteoarthritis.

It involves replacing part or all of the knee joint. It is highly effective, though recovery takes time and effort. Patients typically improve steadily over several months, with continued progress up to a year.

Data from the National Joint Registry shows that around 90 percent of knee replacements are still functioning well at 18 years.

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15:20 – Conventional vs Robotic Surgery

Conventional knee replacement uses alignment guides and the surgeon’s experience to position the implants.

Robotic knee replacement uses detailed mapping of the patient’s anatomy. The knee is assessed during surgery, allowing for highly personalised planning.

The robot does not operate independently. The surgeon remains in control at all times. The robotic system assists by guiding bone cuts and ensuring the surgical plan is executed accurately.

The benefits of robotic surgery include improved precision, better alignment, and more personalised outcomes. Evidence suggests this may lead to improved function, reduced pain, and faster recovery.

However, it is important to note that knee replacement surgery is already highly successful, and robotic assistance is an enhancement rather than a requirement.

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27:30 – Q and A Session

Thank you for that presentation, Mr Oni. It was very informative. We have a number of questions.

One question is, how long does a knee replacement last?

According to current data, most people only need one knee replacement. Around 90 percent are still functioning at 18 years, and many last 20 to 30 years with modern materials.

Another question is about recovery time and returning to exercise.

Patients are usually in hospital for one to two days. By six weeks, movement has improved, although discomfort may remain. By three months, many return to higher levels of activity. Improvement continues up to one year. Recovery depends heavily on rehabilitation effort.

A question was asked about hypermobility.

Hypermobility does not negatively affect outcomes. In many cases, patients experience improved stability after surgery.

What are the risks of failure?

Complications such as infection or bleeding are rare, occurring in around one to two percent of cases. A small percentage of patients may not experience significant improvement, and this depends on individual factors.

There was a question about BMI and eligibility.

While there is no absolute limit, risks increase significantly above a BMI of 40. Patients are often advised to reduce weight before surgery to improve safety and outcomes.

What about waiting times?

Private patients may undergo surgery within four to six weeks, depending on assessment. NHS waiting times are typically three to six months, although this varies.

A question about meniscal tears and arthroscopy.

If symptoms are mechanical, such as locking or giving way, arthroscopy may help. If the main symptom is pain from arthritis, it is less likely to be beneficial.

There were several questions about pain relief.

Pain management is individual and often involves trial and error with medication. Treatment depends on identifying the exact cause of pain.

Does diet affect arthritis?

While not definitively proven, diets rich in anti inflammatory foods, such as omega 3, may help. Diets high in processed foods and sugar may worsen inflammation.

What about cortisone injections?

They can provide temporary relief but are not a long term solution, as they do not address the underlying joint damage.

A question was asked about Arthrosamid injections.

This is a hydrogel injection that integrates into the joint lining and provides longer lasting relief compared to traditional injections.

Can robotic knee replacement be done on the NHS?

Currently, it is not widely available on the NHS, but this may change in the future as the technology becomes more common.

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47:30 – Closing Remarks

Thank you very much to Mr Oni for his insights and to everyone who joined us.

You will receive a recording of the webinar by email, along with contact details if you have further questions.

Thank you and goodbye.