Knee Replacement Medically reviewed by Thomas D. Ferro, M.D. in Carrollton, TX"

Many do. In the largest analysis of national joint registry data, roughly 82% of total knee replacements and 70% of partial knee replacements were still functioning a quarter century after surgery.[5] Precise positioning is one of the factors that helps a knee replacement reach that milestone.

NanoKnee targets the details that shape how long an implant performs. We combine precise 3D modeling and biomedical engineering with FDA-cleared implants to build a plan that positions and aligns your implant to match your anatomy. Component position and balance are among the factors within a surgical team's control that affect the lifespan of a knee replacement.[2]

NanoKnee is designed for people who need a knee replacement and want to recover at home, stay active, and have their implant planned for their own anatomy. It serves active patients seeking excellent function after surgery, from younger adults to older patients in good general health. Whether you're a candidate depends on your imaging, health, history and goals, all of which your surgeon evaluates at your consultation.

Decades of research and millions of procedures stand behind it. Knee replacement is one of the most commonly performed and most studied operations in the U.S., and the American Joint Replacement Registry has documented more than 4.4 million hip and knee replacements since 2012.[6] Serious complications are infrequent, and certain risks can be lowered through decisions made before surgery. For example, a national analysis of more than 380,000 joint replacements found that spinal (neuraxial) anesthesia was associated with lower 30-day mortality and fewer in-hospital complications than general anesthesia.[7] NanoKnee procedures are performed with spinal anesthesia and sedation by board-certified orthopedic surgeons.

Restricted inverse kinematic alignment (iKA) is the personalized method NanoKnee uses to restore your natural tibial joint line and alignment, staying within safe limits. Healthy knees vary, and a substantial share of adults naturally have knees that don't sit in “neutral” mechanical alignment.[10] In a matched series, patients aligned with iKA reported higher satisfaction and better Oxford Knee Scores at one year than patients aligned to an adjusted mechanical target.[11] Your iKA plan is built from your CT scan before surgery and reviewed by your surgeon.

That depends on how much of your knee is affected. When arthritis is limited to one or two areas, NanoKnee surgeons can perform a partial (unicompartmental) or bicompartmental knee replacement, resurfacing only the damaged one-third or two-thirds of the joint and preserving your ligaments and healthy bone. A randomized trial of 528 patients with arthritis in the inner compartment showed partial knee replacement delivered equivalent improvement with fewer complications.[12][13] Your NanoKnee surgeon will help you weigh the options based on your anatomy and knee condition.

If arthritis affects just one compartment, a Nano partial knee replacement is the least invasive choice, removing the smallest amount of bone and keeping your ligaments in place.[12] For total knee replacement, planning and approach have a bigger effect than incision length. With our advanced 3D modeling, NanoKnee surgeons can use a quadriceps-sparing approach for appropriate candidates, reaching the joint without cutting the quadriceps tendon. Randomized trials show this approach reduces pain during the first days of recovery.[8]

Your NanoKnee surgeon uses spinal (regional) anesthesia with a local anesthetic block and “twilight” sedation, so you're comfortable and unaware of the procedure without a general anesthetic. In a national analysis of more than 380,000 joint replacements, spinal anesthesia was associated with lower 30-day mortality and fewer complications than general anesthesia.[7] A general anesthetic remains an option for the rare patients for whom it's safer.

Most patients don't. Because NanoKnee is an outpatient procedure, you'll typically be on your way home from the surgery center within about two hours. A meta-analysis of 20 studies found that appropriately chosen outpatients had complication and readmission rates comparable to inpatients.[9] Before surgery, your surgeon will make sure going home that day suits your health and circumstances.

About 90 minutes. Because your implant's size, position and alignment are already determined in your 3D plan, your surgeon doesn't have to make those choices under time pressure in the operating room.

Most NanoKnee patients walk within 90 minutes of surgery and take on light activities during the first week. A general guide:

• 7–14 days: ordinary daily activities
• 2–4 weeks: activities of moderate intensity
• 4–8 weeks: an active lifestyle

Usually not. Most NanoKnee patients recover through a surgeon-guided home exercise program. You'll begin walking, isometrics and stretching right away, then move on to strengthening, biking, and activities such as golf and hiking. The NanoKnee app lets you track your progress and keep in touch with your care team.

Most NanoKnee patients go on to enjoy activities such as hiking, cycling, golf, tennis, running and skiing.

Most NanoKnee patients regain the knee flexion they need for daily activities and sports, and many get back motion they had lost to arthritis over time. Your 3D plan balances your ligaments through the full range of motion, helping your knee bend and straighten completely. Across 720 NanoKnee patients in our recovery-unit records, median flexion immediately after surgery was 125°, with the middle half of patients between 120° and 134°.

Your incision should heal in about two weeks, but you'll protect the area for the first two to three months. Each NanoKnee procedure finishes with a cosmetic, plastic-surgical closure designed to reduce scarring.

As with any knee replacement, possible risks include infection, blood clots, stiffness, instability, implant loosening over time, and the risks of anesthesia. NanoKnee's surgical processes and proprietary 3D Blueprinting® are designed to address specific risks: spinal anesthesia is associated with fewer perioperative complications than general anesthesia, [7] and pre-operative 3D planning targets the position and balance problems that are among the leading causes of early revision.[1] Your NanoKnee surgeon will discuss the risks relevant to you.

Over the months following surgery, most patients see their function steadily return and their arthritis pain resolve. Mild numbness near the incision and an occasional clicking sound are common and generally not a concern. Your surgeon will monitor your progress and address anything that doesn't improve as expected.

Possibly. Medicare and most commercial health plans cover knee replacement when it's medically necessary, and NanoKnee surgery is billed as a knee replacement. However, insurance doesn't cover the pre-operative 3D planning and engineering, and depending on your plan, you could pay up to $8,500 for that portion. Our patient navigators will confirm your coverage and expected costs before you commit to surgery, and financing is available for non-covered expenses.

Yes. For many people in their later years, a new knee is what restores the ability to walk, travel and stay independent. Rather than setting an age cutoff, NanoKnee surgeons look at your general health, and each patient is fully evaluated before surgery is scheduled. Spinal anesthesia, which NanoKnee uses as standard practice, is associated with fewer perioperative complications than general anesthesia.[7]

NanoKnee's technology is used before surgery, not during it. AI helps our biomedical engineers build a 3D model from your CT scan, your surgeon reviews and approves the resulting plan, and then your surgeon performs the operation with no robot in the room. The precision comes from that detailed pre-operative planning.