Robotic Knee Replacement Surgery | Norton Healthcare Louisville, Ky.

Robot-assisted knee replacement surgery allows for greater precision

Robotic knee replacement surgery helps doctors find the right placement, even adjusting the knee implant by as little as 1 or 2 degrees or millimeters.

Orthopedic surgeon Joseph W. Greene, M.D., with Norton Orthopedic Institute, does hundreds of knee replacement surgeries every year. Now, he works alongside a robotic knee replacement surgical system that offers more precision, leading to a more natural-feeling knee.

Dr. Greene is the first surgeon in Louisville to use the system, ROSA Knee.

“The main benefit of this technology is the ability to fine tune what you’re doing in the operating room with the position of implants while respecting the patients’ natural ligament and tendon movements.,” Dr. Greene said. “This is something that gives the surgeon and the surgical team a ton more information.”

Not everyone’s joints are the same, and ROSA helps guide Dr. Greene during surgery to find the right placement, even adjusting the knee implant by as little as 1 or 2 degrees or millimeters.

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Robotic knee replacement surgery and recovery time

“This allows you to correctly compensate for that variability in the human anatomy,” Dr. Greene said.

According to Dr. Greene, the result is that the knee implants should feel more natural, which could speed recovery.

After the FDA approved ROSA Knee in 2019, Dr. Greene underwent special training to use the robotic surgical system.

“I think this new wave of robotics and smart technology in the operating room gives you the ability to be even more of a fine-detail surgeon,” said Dr. Greene, who is hip and knee reconstruction fellowship director at Norton Brownsboro Hospital and a clinical instructor at the University of Louisville School of Medicine Department of Orthopedic Surgery.

Teaching the next generation of orthopedic surgeons

Because ROSA Knee gives a lot of real-time data, according to Dr. Greene, was also is excellent tool for teaching knee surgery.

“I think from a teaching role, this is huge because what it puts things to numbers that are typically learned through feel and experience. With this technology, surgeons can look on a screen to see what’s happening to the knee replacement through a range of motion,” he said.

A Louisville native, Dr. Greene did his fellowship in New York City, with the Insall Scott Kelly Institute at Lenox Hill Hospital. His fellowship directors wrote the definitive textbook on knee surgery, “Surgery of the Knee.” They are world-renowned for their work on prosthetic knee replacement design, and Dr. Greene began using this technology while he was still a knee surgeon in training.

“When I was there, robotics was in its infancy of development. I trained with a robot in my fellowship, and afterward I tested different robotic machines by different companies,” Dr. Greene said.

Previous robotic systems required computed tomography (CT) scans prior to surgery, which exposed patients to radiation, something Dr. Greene didn’t like doing. ROSA Knee doesn’t. Instead, it uses different sensors on normal X-rays to create a 3D picture. These images then provide detailed numbers and graphs during surgery which assist in identifying the correct size and exact placement of the implant.


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