Robotic-assisted knee surgery comes to Sentara Leigh Hospital

Total knee replacement (TKR) surgery has been commonplace since the 1970s. Since then, orthopedic surgeons have done millions of successful operations over the last five decades.

Earlier this year, Sentara Leigh Hospital adopted a new tool that promises to keep them on the cutting edge of TKR technology: the VELYS™ Robotic-Assisted Solution.

The system is composed of a high-speed camera, optical trackers and a robotic arm. The camera and trackers generate highly detailed data about the patient’s anatomy, and the robotic arm can make extremely precise cuts. For surgeons, VELYS technology represents a real leap forward and gives them another option when performing a knee replacement.

“This is a nice investment by Sentara, “says Dr. Samuel Robinson, an orthopedic surgeon with Sentara Leigh Hospital. “They understood that this is the cutting edge of orthopedics for the future.”

Better data and increased precision

What excites Dr. Robinson about this new tool is the amount of high-quality, quantifiable data the VELYS system provides about the patient’s knee joint. He uses that data in tandem with the robotic arm to increase precision.

“When you do a standard knee replacement, it’s not as easy to adjust everything in the moment, not as precise,” says Dr. Robinson. “With the robot, you can move every parameter to get it even more balanced.”

Dr. Robinson, along with two other orthopedic surgeons who perform TKRs at Sentara Leigh, underwent extensive industry-led training to learn how to properly use the VELYS system. This rigorous process and years of training as an orthopedic surgeon guide the surgery team so it can successfully integrate the robotic system into existing operating room procedures.

“We learned concepts and techniques to specifically use with the robots, then we practiced on cadavers, Dr. Robinson says. “The training was pretty thorough about making sure you understand the concepts and, on top of that, the practical application of it. It takes some experience to know how to use all the capabilities the robot has to offer.”

Another tool in the toolbox

While the VELYS Robotic-Assisted Solution represents a technological advancement in orthopedic surgery, patients still must rely on an experienced surgical team. The team includes an orthopedic surgeon, OR technicians, nurse anesthetists, anesthesiologists and other assistants.

"With the team's help, we can only do what we do for the patients," says Dr. Robinson. He adds that his team is still doing robotic-assisted and traditional TKR. Patient outcomes are similar for both.

“As of 2024, we’ve not proven that patients who get robotic-assisted TKR surgery get a better result than those who do not,” Dr. Robinson adds. “It’s too early in the follow-up progression to say with any definitive conclusion. But it does provide more options in the operating room and allows for more precision. Our hope over time is that it does get better outcomes.”

According to Dr. Robinson, the biggest predictor of a patient’s success with TKR is not whether surgery was performed with the help of robotics. Instead, it’s their expectations going into the procedure and how dedicated patients are to their physical therapy after surgery.

The human factor

Ann Phillips, an orthopedic patient navigator at Sentara Leigh, says another factor that patients need to consider is their support network after surgery. Sentara joint replacement patients must attend an online pre-op class so they know how to prepare and what to expect. Coaches or caregivers are also encouraged to view the pre-op class.

TKR is largely an outpatient procedure, with most patients starting physical therapy within hours after surgery and going home the same day. This pace means they’ll need to think about who will support them during recovery and how they’ll need to be supported.

“Sometimes people don’t understand ahead of time what’s required in the way of support. You’re going to need a coach, a drill sergeant, a cheerleader, someone looking out for you,” says Phillips, adding that the level of support will differ depending on each patient’s unique needs.

Ultimately, Phillips believes that while robotic-assisted technology is a valuable addition to Sentara Leigh Hospital, the human factor will always be the most important when it comes to patient outcomes. To that end, Sentara provides resources like our OrthoJoint Center education page – another way to ensure patients know what to expect and come prepared.

“The robot is a tool,” says Phillips. “What you come in with – attitude, preparation, expectations – that’s what will determine in large part your outcome.”

Learn more about Sentara’s joint replacement program.