How robotic arms are revolutionising knee and joint replacements

Free Malaysia Today

14-05-2025

Pantai Hospital Kuala Lumpur consultant orthopaedic surgeon Dr Rizal Abdul Rani leading a demonstration of the Mako SmartRobotics system. (Moganraj Villavan @ FMT Lifestyle)
PETALING JAYA : When a medical checkup revealed she would require knee replacement surgery, retiree Sally Lim was understandably apprehensive. Since last May, she had been plagued by persistent knee pain, sometimes so debilitating she was rendered immobile.
X-rays confirmed she was suffering from stage-four osteoarthritis. To manage the condition, Lim first pursued alternative treatments such as gel injections and analgesics, but these only offered fleeting relief.
Her turning point came after she discovered that Pantai Hospital Kuala Lumpur offers Mako robotic-assisted surgery – a groundbreaking innovation in the field of joint replacement.
'I remember being very impressed when I first saw the robotic arm. It looked like something straight out of a medical drama,' Lim told FMT Lifestyle.
'I did some research and learnt that this method involves less post-operative pain due to its precision, and recovery times are significantly shorter. I can attest that all this is true.'
Lim's surgery was performed by Dr Sivananthan Kanagarayar, who has been a consultant orthopedic surgeon at the hospital since 2009.
Lim's operation was successfully performed by Dr K Sivananthan, assisted by the Mako SmartRobotics system.
According to Sivananthan, traditional joint-replacement techniques have existed for over 70 years, primarily developed in the United States and the United Kingdom. In Malaysia, such procedures were first introduced during the 1980s.
These methods, he explained, had been instrumental in alleviating the pain of patients who suffered from conditions such as arthritis, which was sometimes so intense it disrupted their daily lives.
'Conventionally, joint replacement requires us to make bone cuts to accommodate the implants. These cuts are usually guided by jigs (a type of template or guide used to ensure accurate bone preparation for surgery), which must be rotated with meticulous precision – sometimes by just two or three degrees.
'While traditional methods yield fairly satisfactory results, there can occasionally be complications, such as excessive ligament release when the knee is straightened. With robotic assistance, we can significantly mitigate such risks.'
Mako SmartRobotics systems use advanced real-time 3D imaging and robotic guidance to create personalised surgical plans tailored to each patient, allowing for optimal implant placement.
The procedure is especially suited for partial or total knee replacement, as well as hip replacement surgery.
Mako SmartRobotics systems use advanced real-time 3D imaging and robotic guidance to create personalised surgical plans tailored to each patient. (Moganraj Villavan @ FMT Lifestyle)
In Lim's case, Sivananthan conducted a specialised CT scan of her leg, which was sent to the Mako unit in the US. Upon receiving their comprehensive report, he collaborated with a Mako technician to plan out the operation.
'On the day of the surgery, this data is mapped onto the patient's knee, and the bone cuts are made with robotic assistance. The level of precision surpasses the capability of the human eye.
'Moreover, the robot is equipped with haptic feedback technology, preventing it from making incisions beyond the predetermined boundaries,' he explained.
According to him, surgeons traditionally rely on mechanical alignment to match the knee replacement with the hip and ankle. Today, thanks to a concept known as kinematic alignment, robots can perform this task with significantly higher accuracy.
Sivananthan emphasised that while the Mako robotic arm enhances precision, it is still the expertise of skilled surgeons that ensures the success of the procedure.
'In my experience, patients who undergo robotic-assisted surgery often return to their normal routines more swiftly and express high satisfaction with the results,' he added.
The Mako system being tested on a model of a human leg. (Moganraj Villavan @ FMT Lifestyle)
Sivanathan further underscored the importance of post-operative physiotherapy, typically spanning three months, to achieve full recovery and optimal joint function.
While knee replacement is more commonly associated with elderly patients, he pointed out that he has operated on individuals across a wide age range.
He advises consulting a medical professional if routine activities became challenging, or if long-distance walking grows increasingly painful.
It has now been seven months since Lim underwent surgery, and she is thrilled to report that her chronic knee pain is a thing of the past.
'The doctor told me, 'If you can bend your knee to 90 degrees within six weeks, you can start driving again.' I was determined to do it. Now, I can drive again,' Lim said, smiling.
'My advice? Trust your doctor, do your homework, and take the leap. You might reclaim the quality of life you thought you'd lost.'
For more information, check out Pantai Hospital Kuala Lumpur's website.