Knee replacement is already one of the most successful operations in orthopedics. Robotic assistance makes it more precise.
Dr. Leo Zalikha uses robotic-assisted technology for both total knee replacement and partial knee replacement. The system creates a CT-based, three-dimensional plan specific to your knee before surgery begins. During the operation, it provides real-time guidance to help execute that plan with sub-millimeter accuracy.
The result is a knee replacement that is positioned and balanced to match your individual anatomy rather than a population average.
The knee is a more complex joint than the hip. It has multiple compartments, relies on ligaments for stability, and must flex, extend, and rotate smoothly through a full range of motion. Unlike the hip (a ball-and-socket), the knee’s function depends heavily on getting the alignment, rotation, and soft tissue balance right.
Small deviations in implant positioning can lead to:
This is why Dr. Zalikha uses robotic-assisted technology. It reduces the variability in implant placement that exists with manual instrumentation alone.
Before surgery, a CT scan of your knee creates a precise 3D model of your bone anatomy. Dr. Zalikha uses this model to plan the size, position, rotation, and alignment of each implant component. The plan takes into account your specific bone geometry, existing deformity (if any), ligament tension, and the goal of restoring a natural mechanical axis. This is not a generic template. It is a surgical plan built for your knee.
During surgery, the robotic system registers your actual bone anatomy using optical tracking. It then overlays the surgical plan onto your real-time anatomy. As Dr. Zalikha makes bone cuts, the system provides continuous feedback on depth, angle, and rotation. For the total knee, this means each of the four to five bone cuts is guided by live data rather than relying solely on mechanical alignment guides. For partial knee replacement, robotic assistance is particularly valuable because preserving healthy bone and cartilage requires even greater precision.
One of the most important aspects of knee replacement is balancing the soft tissues: the ligaments and other structures that determine how tight or loose the knee feels through its range of motion. Robotic-assisted surgery provides objective data on ligament tension during the procedure, helping Dr. Zalikha achieve a balanced knee that feels stable without being stiff.
Robotic-assisted knee replacement has been studied in multiple clinical trials and registry analyses. The evidence consistently shows:
Long-term data on implant survival with robotic technology is still accumulating, as the technology in its current form is relatively recent. Early and mid-term results are encouraging.
The robotic system is a precision tool. It helps the surgeon execute a plan more accurately.
The technology is only as good as the surgeon using it. Dr. Zalikha trained in robotic-assisted arthroplasty during his fellowship at Stanford Medicine and uses it as standard practice for knee replacement.
For a detailed comparison of the two approaches, see our guide on robotic vs. traditional knee replacement.
Robotic assistance is especially well-suited for partial (unicompartmental) knee replacement. Because partial knee replacement preserves the healthy compartments of the knee, precise bone preparation is critical. Removing too much or too little bone, or positioning the implant even slightly off-plan, can affect the mechanics of the preserved compartments.
The robotic system allows Dr. Zalikha to execute partial knee replacement with the accuracy needed to preserve the natural ligaments and healthy cartilage while replacing only the damaged compartment.
