Robotic-Assisted Partial and Total Knee Replacement in London
Robotic-assisted partial and total knee replacement removes arthritis-damaged joint surfaces and fits metal and plastic implants. A robotic arm keeps each bone cut to a pre-set plan. Mr Sivan Sivaloganathan, Consultant Orthopaedic Surgeon in London, plans each case and performs it personally. According to the NHS, the operation usually lasts 1 to 2 hours.
It is meant for adults whose arthritis still limits walking, sleep or work after exercise, weight loss and painkillers. That is the threshold set by NICE guideline NG226. Mr Sivaloganathan operates with the robotic arm at King Edward VII’s Hospital in Marylebone and at Chelsea Private Care, Chelsea and Westminster Hospital.
A partial replacement resurfaces 1 of the knee’s 3 compartments (Versus Arthritis), and a total replacement resurfaces the whole joint. Re-do operations and badly deformed knees are on his robotic complex knee replacement page.
What Is Robotic-Assisted Knee Replacement?
Every knee replacement takes worn bone surface from the lower thigh bone and upper shin bone, then caps both with new parts. The NHS guide to knee replacement names osteoarthritis as the most common reason for the operation.
Planning starts before theatre. A CT or MRI scan of your knee becomes a 3D plan for the size and position of each implant. During surgery the system maps your knee, and Mr Sivaloganathan tests how the ligaments behave as it bends and straightens.
He then makes the bone cuts with a robotic arm that keeps the saw inside the boundary set by the plan. The arm never moves on its own. He holds and directs it throughout, and can change the plan at any point during the 1 to 2 hour operation.
The technique is growing but still a minority choice. Robot-assisted joint replacements rose 68% over 3 years, and the National Joint Registry recorded 11,641 robotic knee procedures in 2025. That is still small next to conventional surgery.
Knee Symptoms and When to Get Urgent Help
Arthritis in the knee usually builds over years. The NHS osteoarthritis page lists pain, stiffness, swelling and a grating feeling as the joint moves. After any knee operation, a few new signs need attention the same day.
| Your symptom | Possible cause | What to do |
|---|---|---|
| Pain, stiffness or grating that limits walking, stairs or sleep | Osteoarthritis (NHS) | See your GP or book an assessment with Mr Sivaloganathan |
| Knee locks, gives way or clicks painfully | A mechanical problem inside the joint (NHS) | Get advice from NHS 111 |
| Hot, red, swollen knee with a high temperature | Possible joint infection (NHS) | Urgent GP appointment or NHS 111 the same day |
| Throbbing pain or swelling in one calf after surgery | Possible blood clot, known as DVT (NHS) | Urgent GP appointment or NHS 111 |
| Leg pain or swelling with breathlessness or chest pain | Possible clot in the lungs (NHS) | Call 999 or go to A&E |
| Confusion, slurred speech, blotchy skin or very fast breathing | Possible sepsis (NHS) | Call 999 or go to A&E |
The NHS page on deep vein thrombosis warns that a clot can travel to the lungs, which needs treatment straight away. Signs of sepsis always mean 999 or A&E, whatever the operation (NHS).
Conditions Mr Sivaloganathan Treats with Knee Replacement
- Arthritis on the inner side of the knee: wear limited to 1 compartment. NICE NG157 (1.7.1) says these patients should be offered a choice of partial or total replacement.
- Arthritis across the whole knee: wear in 2 or 3 compartments, which usually calls for a total replacement (Versus Arthritis).
- Arthritis that has pulled the leg out of line: bow legs or knock knees are measured on the planning scan. The 3D plan then sets how much correction your knee needs.
- Rheumatoid and other types of arthritis: the NHS lists these as less common reasons for knee replacement. Severe instability or bone loss is assessed for robotic complex knee replacement.
- Arthritis after an old injury: the NHS lists this as another cause. Recent tears and sprains are covered on knee injuries and meniscal repair.
Treatment Options: Partial or Total Knee Replacement
Both operations use the same planning scan and robotic arm. The choice turns on how much of the knee is worn and how healthy the ligaments are. NICE guideline NG157 asks surgeons to discuss the benefits and risks of each, including the chance of more surgery later (recommendation 1.1.2).
Robotic Partial Knee Replacement
Only the worn compartment is resurfaced, usually the inner side, and healthy cartilage and ligaments are left alone. It suits people whose arthritis sits in 1 compartment and whose ligaments are strong, says Versus Arthritis. The NHS describes a smaller cut and a quicker recovery than a total knee.
Theatre time is about 1 to 2 hours, and the NHS gives 1 to 4 days in hospital. The main trade-off is durability. Versus Arthritis says about 1 in 10 people need further surgery within 10 years, and the NJR names spreading arthritis as the top reason.
Robotic Total Knee Replacement
The lower thigh bone and upper shin bone are both resurfaced, and NICE NG157 (1.7.2) recommends offering a new kneecap surface too. It suits arthritis in more than 1 compartment, or ligaments too worn for a partial.
Theatre time is again 1 to 2 hours, and the NHS quotes a 1 to 4 day stay. Versus Arthritis puts deep infection at about 1 in 100. The NJR’s 2026 report gives a 5.22% chance of revision by 20 years for cemented fixed-bearing total knees.
| Point to compare | Partial knee replacement | Total knee replacement |
|---|---|---|
| Part of the knee replaced | 1 compartment, usually the inner side (Versus Arthritis) | Ends of the thigh and shin bones, often the kneecap (NHS, NICE) |
| Cut and recovery | Smaller cut, quicker recovery (NHS) | Larger cut, longer recovery (NHS) |
| Driving | After about 3 weeks (NHS) | After about 6 weeks (NHS) |
| Further surgery | About 1 in 10 within 10 years (Versus Arthritis) | 5.22% revised by 20 years, cemented fixed-bearing (NJR) |
Mr Sivaloganathan goes through these trade-offs with you using your own scan. Versus Arthritis notes that ligament health is sometimes clear only once surgery starts, so the final choice is sometimes made in theatre.
Why Patients Choose Mr Sivaloganathan for Robotic Knee Surgery
- Hospitals: robotic operations at King Edward VII’s Hospital, Marylebone, and Chelsea Private Care at Chelsea and Westminster Hospital, with clinics at 4 more London and Middlesex sites.
- Qualifications: a medical degree from Imperial College London and a master’s degree (MSc) from UCL in nanotechnology and regenerative medicine (award years and postnominals [to confirm]).
- Training: specialist orthopaedic posts in South West London. A fellowship followed in Montreal, Canada, in a unit for complex hip and knee surgery (scholarship-funded, 2021). Back in London, a further fellowship combined robotic complex knee surgery with complex trauma at Imperial College Healthcare NHS Trust.
- Research: 18 papers in PubMed-indexed journals, centred on personalised knee replacement that keeps the knee’s own alignment.
- Teaching: invited international faculty on personalised joint replacement. Since 2025 he has been faculty on a Visiting Surgeon Programme, where surgeons from abroad watch his robotic technique.
- Service: 7 years as a Medical Officer in the regular British Army, reaching Captain, including a 2009 tour of Afghanistan.
How Long Will a New Knee Last, and Does the Robotic Arm Change That?
The NHS page on knee replacement complications says most knee replacements last for about 25 years. Versus Arthritis says 80 to 90% of total knees should last about 20 years.
The National Joint Registry follows replacements across England, Wales and Northern Ireland. Its 2026 report gives a 5.22% revision chance by 20 years for cemented fixed-bearing total knees, from over 1 million operations. Partial knees are revised about 3 times as often as cemented total knees at 10 years, and more often in younger people.
Personalised alignment is the focus of his research. Instead of setting every knee to 1 straight line, the plan aims to keep your knee’s own angles within safe limits.
The evidence on robots is still being gathered. NICE HealthTech guidance HTG743 (April 2025) found implant alignment was more accurate with robotic surgery. It found patient-reported outcomes and complications were similar to conventional surgery so far. NICE allows NHS use while 3 years of further evidence is collected.
The NJR’s 2026 report says the same: a clear fall in revision rates has not yet been shown. On a 48-point patient questionnaire (the Oxford score), average results rose from 18.5 before a first knee replacement to 35.5 after, robotic or not (NJR). Mr Sivaloganathan will explain what the robotic arm can and cannot change for your knee.
Alternatives to Knee Replacement Surgery
Surgery is a choice, not a deadline. NICE guideline NG226 makes exercise and weight management the core treatments for osteoarthritis. For weight, NICE judges a 10% loss likely to beat a 5% loss.
The NHS page on alternatives to knee replacement adds walking aids, shoe insoles, painkilling gels or tablets and steroid injections into the joint. NICE NG226 says a steroid injection eases pain for only 2 to 10 weeks. His knee pain management and injections page covers these in detail.
Some knees suit other operations. The NHS lists osteotomy, which reshapes the shin bone to take load off the worn side. NICE NG226 (1.7.1) advises against keyhole washout for osteoarthritis alone, as his knee arthroscopy and meniscal surgery page explains.
Holding off is sensible while the knee stays manageable. Under NICE NG226 (1.6.3), age, body weight or smoking should never on their own block a later referral.
Your Pathway, Step by Step: Appointment, Planning Scan and Surgery
- Referral: if you pay for yourself, no referral is needed. People using health cover should ask their provider whether a GP letter is required.
- First consultation: at 1 of his 6 London clinics, with your history, an examination and a review of your X-rays or scans.
- Planning scan: a CT or MRI scan builds the 3D plan used by the robotic arm. NICE HTG743 lists this pre-operative imaging as part of robotic knee surgery.
- Preparing: NICE NG157 (1.2.1) advises exercises before surgery, weight management and stopping smoking. A pre-admission check with blood tests follows a few weeks before (NHS).
- Your decision: you choose partial, total or no surgery yet. NICE NG157 (1.3.2) says you should be offered a choice of general or spinal anaesthetic, with local pain relief in the knee.
- Theatre day: you come into hospital that morning (NHS). NICE NG157 (1.10.1) says physiotherapy should start the same day, or within 24 hours.
Recovery and Risks After Robotic Knee Replacement
His page gives a typical stay of 2 to 3 days, within the 1 to 4 days the NHS quotes. Crutches or a frame support you for the first weeks. In the NHS knee replacement recovery guide, stitches or clips come out near day 10, with a review at about 6 weeks.
Driving usually returns after 3 weeks for a partial knee and 6 weeks for a total (NHS). Most people return to work after 6 to 12 weeks. Lifting and heavy housework wait for 3 months.
Versus Arthritis says about 1 in 20 people have a complication, and most are minor. Wound infection affects about 1 in 50 people and deep infection about 1 in 100. Fewer than 1 in 100 have nerve damage. Between 10 and 20% still have moderate or severe pain in the long term.
Blood clots are the other main risk. The NHS advises compression stockings for at least 6 weeks, and you may also be given blood-thinning injections or tablets.
| Treatment | Hospital stay | Example risk |
|---|---|---|
| Robotic partial knee replacement | Usually 1 to 4 days (NHS) | About 1 in 10 need further surgery within 10 years (Versus Arthritis) |
| Robotic total knee replacement | Usually 1 to 4 days (NHS) | About 1 in 100 develop a deep joint infection (Versus Arthritis) |
| Any knee replacement | Usually 1 to 4 days (NHS) | About 1 in 50 have a wound infection (Versus Arthritis) |
| Any knee replacement | Usually 1 to 4 days (NHS) | 10 to 20% have moderate or severe long-term pain (Versus Arthritis) |
| Cemented fixed-bearing total knee | Usually 1 to 4 days (NHS) | 5.22% revised by 20 years (NJR 2026) |
Typical milestones for the first 3 months come from NICE, the NHS and Versus Arthritis.
| When | What to expect | Source |
|---|---|---|
| Within 24 hours | First walk with a physiotherapist, using crutches or a frame | NICE NG157, NHS |
| About 10 days | Stitches or clips removed | NHS |
| 3 weeks | Driving after a partial knee, if you can do an emergency stop | NHS |
| 6 weeks | Driving after a total knee, walking without aids, follow-up check | NHS |
| 6 to 12 weeks | Back to work, depending on the job | NHS |
| 3 months | Heavy housework, kneeling on a soft surface | NHS, Versus Arthritis |
Where Mr Sivaloganathan Sees Patients in London
Robotic operations take place at King Edward VII’s Hospital and Chelsea Private Care. Consultations run at 6 sites across London and Middlesex. Use the booking form to choose a clinic.
| Location | Address | Clinic times |
|---|---|---|
| King Edward VII’s Hospital | 5–10 Beaumont Street, London W1G 6AA | Wednesday, 9:30am to 12:30pm |
| Chelsea Private Care, Chelsea and Westminster Hospital | 369 Fulham Road, London SW10 9NH | Monday mornings |
| Syon Clinic | 941 Great West Road, Brentford TW8 9DU | Monday, 5:30pm to 8pm |
| Clementine Churchill Hospital | Sudbury Hill, Harrow HA1 3RX | Monday, 12pm to 2:30pm |
| Chiswick Outpatients | Bond House, 347–353 Chiswick High Road, London W4 4HS | Building open Monday to Friday, 8am to 8pm |
| The Lister Hospital | Chelsea Bridge Road, London SW1W 8RH | Building open Monday to Friday, 8am to 6pm |
Fees and Insurance for Robotic Knee Replacement
His fees for 2026 are not listed online. Ask the practice for both consultation and surgery costs before deciding.
Mr Sivaloganathan sees self-paying patients and patients insured with AXA Health, Aviva, Bupa and Healix.
Patients with a different insurer can check their cover through the contact form.
FAQs About Robotic Knee Replacement
Is a robotic knee replacement major surgery?
Yes. Expect 1 to 2 hours in theatre under a general or spinal anaesthetic, then 1 to 4 days on the ward (NHS). Versus Arthritis says about 1 in 20 people have a complication, most of them minor.
Does the robot operate on its own?
No. Mr Sivaloganathan guides every cut, and the arm only stops the saw going past the boundary in your plan. Under NICE HTG743, everyone in the surgical team must first train on the specific robotic system in use.
How long is the recovery after a partial or total knee replacement?
Most people walk with crutches within a day and move to a stick over the first 6 weeks (NHS). Work usually resumes at 6 to 12 weeks. Versus Arthritis says the knee keeps improving for up to 2 years.
When will I be able to drive again?
The NHS says wait at least 3 weeks after a partial knee and 6 weeks after a total knee. Being able to brake hard in an emergency is the real test. Check that your motor cover is valid during recovery (Versus Arthritis).
Can arthritis come back after a partial knee replacement?
It can develop in the parts of the knee that were not replaced. The NJR names progressing arthritis as the most common reason cemented partial knees are revised. Versus Arthritis puts the chance of further surgery at about 1 in 10 within 10 years.
Will I need a scan before robotic surgery?
Yes. A CT or MRI scan of your knee builds the 3D plan for the robotic arm (his site). NICE HTG743 lists this imaging as part of robotic knee surgery. A pre-admission check a few weeks before includes blood tests (NHS).
What can I try instead of a knee replacement?
Start with exercise and weight loss, then add walking aids, shoe inserts, painkillers or a steroid injection (NHS). NICE NG226 suggests surgery when these have not worked and symptoms still affect your quality of life.
How much does a robotic knee replacement cost?
Fees are not published online. Ask the practice for the 2026 consultation and surgical costs before you commit to anything.
Will I be able to kneel on my new knee?
Versus Arthritis suggests trying a soft surface after 3 months. Kneeling may never feel fully comfortable, but it usually gets easier as the scar firms up.
Does a robotic knee last longer than a conventional one?
That has not been shown yet. NICE HTG743 (2025) and the NJR’s 2026 report both say robotic surgery has not yet shown lower revision rates. Most knee replacements last about 25 years, says the NHS.
Book a Robotic Knee Replacement Consultation with Mr Sivan Sivaloganathan
Book a consultation to learn whether your knee suits robotic-assisted partial and total knee replacement, or whether non-surgical care should come first. Bring your most recent X-rays, any scan reports and your current medicines.
- Phone: Call the practice on [to confirm], or use the online forms below.
- Online: pick a clinic and time through the appointment booking form, or send your question via the contact form.
His blog explains when knee replacement surgery is needed, how long the operation takes and the stages of healing after a knee replacement. Every treatment he offers is on the treatments page.
Phone your GP surgery or NHS 111 that day about a knee that turns hot and swollen, a sore swollen calf or a wound that leaks fluid. Chest pain, breathlessness or sepsis signs such as new confusion or mottled skin call for 999 or a trip straight to A&E.