Advanced robotic technology has entered the orthopaedic wards of Safdarjung Hospital, Delhi, with its orthopaedics at the Central Institute of Orthopaedics (CIO) performing the first robot-assisted total knee replacement. This potentially opens access to a technology often associated with high-cost private healthcare.
The procedure was performed on August 22 on a 75-year-old man from an economically weaker sector and was provided free of cost under the Ayushman Bharat scheme, the hospital said.
The development is significant in a country where knee problems, particularly osteoarthritis, are becoming an increasingly important cause of pain, disability and loss of mobility among older adults. For many patients, severe knee arthritis eventually makes walking, climbing stairs and even routine daily activities difficult.
The hospital's move is therefore not merely about introducing a new machine. It could help bring greater precision in joint replacement surgery within the public healthcare system, where economically backward patients often face long waiting periods and limited access to advanced surgical technologies.
Robotic-assisted surgery does not mean that a robot independently performs the operation. The surgeon remains in control throughout the procedure, said the doctors.
The operation was led by Dr Bhagwati Prasad Sharma, Consultant Professor and Head of Unit, along with Dr Dhruve Maini and Dr Kartik Yadav. The anaesthesia team was led by Dr Sushil Guria, with nursing support from Rekha and Ritika and technical assistance from Vijender.
The technology helps create a detailed pre-operative plan and assists the surgical team in executing bone cuts and positioning the knee implant with greater precision. It can help surgeons assess alignment and positioning during the procedure, potentially improving the accuracy of implant placement.
This can be particularly useful in complex cases where achieving the desired alignment and balance of the knee is challenging.
However, robotic assistance is not a guarantee of a better outcome for every patient. The skill and experience of the surgeon, appropriate patient selection, rehabilitation and management of other health conditions continue to remain crucial.
The burden of knee osteoarthritis is substantial and is expected to grow as India's population ages, obesity increases and people live longer.
Knee osteoarthritis can severely affect quality of life. In advanced disease, when pain and disability persist despite medicines, physiotherapy and other non-surgical measures, total knee replacement may be considered.
For patients in the public health system, access to such procedures can be particularly important because robotic-assisted surgery can otherwise involve considerable additional costs in private hospitals.
The Safdarjung initiative could consequently have a wider implication if the technology is used to provide advanced surgery to economically disadvantaged patients without adding prohibitive costs.
The robotic platform installed at CIO is upgradable and can potentially be used for partial knee replacement and hip replacement as well, said the doctor.
The hospital has also indicated that after future technological and software upgrades, the platform could support robot-assisted spine surgery.
This means the first knee replacement is being viewed as the beginning of a broader technology-enabled orthopaedic programme rather than an isolated procedure.
But technology alone cannot solve the problem.
The introduction of robotics comes against the backdrop of a growing demand for joint replacement and orthopaedic care.
For patients, the bigger challenge remains timely diagnosis and treatment. Many elderly people continue to live with severe knee pain for years, either because they consider it an inevitable part of ageing or because advanced treatment remains financially out of reach.
However, experts generally emphasise that knee replacement should not be the first response to knee pain. Weight management, physical activity, physiotherapy, appropriate medicines and other conservative measures can help many patients, particularly in earlier stages of arthritis.
