January 14, 2020

Are You Considering a Knee Replacement Surgery?

By Dr. Gregory J. Hicken

If you have severe osteoarthritis in your knee, no doubt you are considering full or partial knee replacement surgery (also known as an arthroplasty) in which your joint is restored by resurfacing the bones and installing an artificial knee implant.

Knee Replacement, Then and Now

Technology for knee replacement surgery has improved immensely. In the 1980s, knee replacements were delayed for as long as possible, leaving the patient to suffer stiffness, pain, and mobility limitations. The cement and implant would wear out after a few short years, and replacements were even more challenging to perform than the  original procedures.

What was previously only permitted in a full-service hospital as an inpatient procedure is now being done safely in an outpatient setting away from a hospital. In fact, Medicare will begin authorizing knee replacement procedures in freestanding outpatient surgery centers such as St George Surgical Center as of January 1, 2020.

Robotic Surgical Systems for Knee Replacement

Because patients wanted to return to normal everyday activities and have a more active lifestyle after knee replacement, manufacturers designed and developed advanced implants as well as surgical instruments to improve precision and surgical performance.  We now have robotic surgical systems available that improve precision and help surgeons to be consistent regardless of whether they are performing their fifth surgery or their hundredth surgery . Additionally, there are a wide array of prosthetics from which to choose, whether your knee damage involves the entire knee (total) or only one side of the knee (partial). 

Southern Utah Knee Replacement Choices

Here in southern Utah, there are two robotic systems in use to help surgeons perform total knee replacements, but only the NAVIO Surgical System is capable of total and partial knee replacements. And only NAVIOfrom Smith and Nephew offers a prosthetic (the Verilast) that lasts 30 years, a claim that the Food and Drug Administration (FDA) allows.This means that if you need a new knee earlier in life in order to remain active or to return to the lifestyle activities you enjoy, you don’t have to wait years to replace your knee, as was the case in the 1980s. 

Questions To Ask

Here are four questions to ask your surgeon before you decide on knee replacement surgery:

  1. Do you plan to replace the entire knee or just part of the knee?  

With the NAVIO, we have choices of knee replacement prosthetics to offer our patients. Some robotic systems offer only total knee replacement, so even if only part of your knee needs replacement, the other robot can’t offer that option.

     2. Will I need a CT scan before my knee replacement surgery? 

A knee replacement done without robotic assistance may require a CT scan. The surgeon uses this to create their surgical plan and determine the rotational alignment of the prosthetic components. The CT scan is equivalent to forty-eight chest x-rays! With the NAVIOsurgical system, no CT is required.

     3. If you replace my knee without the robot, will my implant loosen to the point it requires a revision or subsequent replacement? 

The NAVIOrobotic surgical system affords the surgeon the opportunity to be more precise, which in turn usually results in a better fit for a longer period of time. When the knee implant is not properly aligned, the patient often experiences pain and mobility limitation. The first symptom of a failing prosthesis is pain; the Australian Prosthetic Register revealed that aseptic loosening accounts for 35 percent of the pain and infection accounts for 17 percent of the pain (1).

     4. Can you spare my anterior cruciate ligament (ACL) with the surgical plan for my knee replacement?

In southern Utah and northern Clark County, only the NAVIOsurgical system offers the option to spare the ACL. If your surgeon isn’t using the NAVIO and your ACL is in good shape, it may be sacrificed unnecessarily

Gregory J Hicken, MD, is committed to providing high-quality orthopedic care. Your health and comfort and the personal attention you deserve are his priority. His goal is to make every visit to his office in Logan, Utah, or St. George, Utah, as comfortable and convenient as possible. Dr.. Hicken’s specialties include:

  • Full and partial robotic-assisted knee replacement
  • Total joint replacement
  • Minimally invasive surgery
  • Sports medicine
  • Shoulder reconstruction
  • Computer-assisted total knee replacement
  • Computer-assisted total hip replacement

Dr. Hicken welcomes new patients to his office, located at 568 W Telegraph Street #4 in Washington, Utah. Please call (435) 627-0231 with any questions and plan to attend an upcoming lunch-and-learn session where Dr. Hicken will answer your questions about robotic-assisted full and partial knee replacement surgeries. You may inquire about dates and reserve your seat by phone.


Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthopaedica Scandinavica. 2000; 71(3):262–267.[PubMed] [Google Scholar]

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