The VELYS™ Robotic-Assisted Solution has now been formally introduced at The Rivers Hospital and Mr Kosuge started performing robotic-assisted total knee replacements this week. It is a good moment to answer the question he is asked most often, which is a fair one. Is a robotic knee replacement better than a conventional one and is it the right choice for you? It is worth answering plainly, because the marketing around robotics can make the decision sound more dramatic than it is.

What "conventional" knee replacement actually means

A conventional total knee replacement is a very well-established operation with an excellent track record. The worn surfaces of the knee are removed and replaced with metal and plastic components and Mr Kosuge uses precise instruments, measurements and experience to position them. The great majority of these replacements perform well for many years. When people worry that "conventional" means old-fashioned, that is not the case. It remains the operation that the long-term registry data is built on.

What the robot adds

Robotic assistance does not replace the surgeon. Mr Kosuge remains in control of the operation throughout. What the system adds is a detailed plan and real-time feedback. Before and during surgery, it builds a picture of your individual knee. It then helps position the implant and balance the soft tissues to Mr Kosuge’s plan with a high degree of accuracy. In published work the VELYS system has been shown to place components within a few degrees of the intended alignment very consistently.

Does more precision mean a better result for you?

This is the honest part. Better alignment and balance are sensible goals and early studies have reported benefits such as improved mobility and shorter hospital stays. What has not yet been proven is that a robotic knee lasts longer than a well-performed conventional one over fifteen or twenty years, because that evidence will take longer to gather. So the fair summary is that robotic assistance is a genuine advance in accuracy and consistency, rather than a guarantee of a different outcome for every patient.

Who benefits most

Robotic assistance can be particularly useful where the anatomy is more challenging or where fine soft-tissue balancing matters. For many patients either approach in experienced hands will give an excellent result. The most important factor remains the surgeon and the whole team around the operation, not the tool alone.

Discussing your options

Mr Kosuge offers both conventional and VELYS robotic-assisted total knee replacement at The Rivers Hospital and will talk through which is more appropriate for your knee at consultation. You can review his published outcome data:

To book an appointment with Mr Kosuge at The Rivers Hospital:

• Online booking

• Telephone: 01279 602675

When you are deciding whether to go ahead with a hip or knee replacement, one of the first questions you will ask is a simple one: “Will it work?” It is the right question — but an honest answer is more nuanced than a single success rate. This is where PROMs come in, and it is why Mr Kosuge was delighted to have been interviewed by PHIN, the Private Healthcare Information Network recently.

What are PROMs?

PROMs stands for Patient-Reported Outcome Measures. They are short questionnaires — usually five to ten minutes to complete — that you fill in before your treatment and again at intervals afterwards. Rather than judging your recovery from a clinical examination or x-rays only, they ask you directly how you feel and how well you can manage everyday activities: walking, climbing stairs, sleeping, getting dressed and returning to the things you enjoy.

Why an x-ray does not tell the whole story

A joint replacement can look normal on an X-ray but still leave a patient not experiencing the improvement they had hoped for. What matters to you is not how the implant looks on a screen; it is whether you can get back to your life with less pain. PROMs capture exactly that: the outcome as you experience it, not just as it is assessed it in the out-patient clinic setting.

Giving you a more personalised answer

Mr Kosuge finds PROMs valuable as they allow him to give a far more individualised answer about what you can realistically expect. General success rates are a useful starting point, but they treat every patient as the same. In reality, outcomes vary with your age, your general health, your activity levels and the specifics of your condition. PROM data — gathered across many patients and then matched to circumstances like yours — helps Mr Kosuge paint a clearer, more honest picture of your likely recovery, rather than quoting a one-size-fits-all figure.

How PROMs help you as a patient

For you, tracking outcomes this way means you can:

•     Make a more informed decision about whether surgery is right for you

•     Set realistic expectations for your recovery timeline

•     Track your own progress in the weeks and months afterwards

•     Gain reassurance that things are moving in the right direction

•     Flag any issue early that a routine check might otherwise miss

The bigger picture

There is a wider benefit too. When PROMs data is brought together across many patients, it helps the whole profession understand which treatments work best for which groups of people. Every questionnaire a patient completes feeds into better, more tailored advice for those who come after them. It is one of the quiet ways private healthcare is becoming more transparent and accountable — something Mr Kosuge strongly supports.

Your options

If you are weighing up hip or knee surgery and would like a clear, realistic conversation about what it could mean for you specifically, Mr Kosuge would be glad to help. You can review Mr Kosuge’s outcomes on this website or book a consultation at Rivers Hospital in Sawbridgeworth.

To book an appointment with Mr Kosuge at The Rivers Hospital:

• Online booking

• Telephone: 01279 602675