Mr Kosuge is pleased to announce that robotic-assisted total knee replacement using the VELYS™ Robotic-Assisted Solution will be available at The Rivers Hospital, Sawbridgeworth, from July 2026. This is a significant development for patients in Essex and Hertfordshire seeking the most advanced approach to knee replacement surgery — one that combines Mr Kosuge's surgical expertise with a technology designed to improve precision and personalise each procedure to the individual patient.

What Is the VELYS™ Robotic-Assisted Solution?

VELYS is a state-of-the-art surgical technology developed by DePuy Synthes, part of Johnson & Johnson MedTech — one of the world's leading orthopaedic companies. The system uses pre-operative planning and real-time intraoperative guidance to assist the surgeon in performing total knee replacement with exceptional accuracy.

Before surgery, a personalised plan is created based on each patient's individual anatomy. During the procedure, VELYS provides continuous real-time data and feedback, helping to ensure the implant is positioned precisely in line with that plan — adjusting dynamically for even the subtlest variations in the patient's anatomy as surgery progresses.

It is important to be clear about what VELYS is and is not. The robot does not operate independently. Mr Kosuge remains entirely in control throughout the procedure. VELYS acts as an advanced assistive tool — enhancing the precision with which the surgery is performed, not replacing the judgement or skill of the surgeon.

Why Precision Matters in Knee Replacement

The accuracy of implant positioning is one of the most consequential factors in knee replacement outcomes. When an implant is correctly aligned to a patient's anatomy and biomechanics, patients typically experience better function, less post-operative pain, and a more natural-feeling result in the replaced knee.

Traditional knee replacement uses mechanical guides and surgical expertise to achieve this alignment — and in experienced hands, outcomes are consistently excellent. VELYS adds a further layer of technological precision, providing objective real-time data to support the surgical plan and helping to ensure consistent accuracy throughout the procedure.

What the Evidence Shows

A peer-reviewed study published in 2025 found that VELYS robotic-assisted total knee replacement was associated with improved mobility, a reduction in hospital stay, shorter surgical duration, and better psychological outcomes compared to conventional approaches. Independent research has also demonstrated greater post-operative range of motion and reduced pain in patients who underwent robotic-assisted procedures.

In one study, all 101 cases achieved the target coronal plane alignment within 3 degrees — a measure of how accurately the implant is positioned in the knee. This level of consistency is a key aim of robotic-assisted surgery and an important contributor to long-term implant function.

Is Robotic-Assisted Surgery Right for You?

VELYS-assisted total knee replacement is suitable for the majority of patients requiring total knee replacement surgery. A consultation with Mr Kosuge will determine whether this approach is appropriate for your specific anatomy, the extent of your joint damage, and your overall health. Not every patient will be an ideal candidate for every technique — Mr Kosuge will always recommend the approach that is best suited to the individual.

For more information about VELYS robotic-assisted surgery.

Book a Consultation

If you are considering knee replacement surgery and would like to discuss whether VELYS-assisted surgery is the right option for you, Mr Kosuge is happy to talk through your situation in detail at an initial consultation. Appointments are available at The Rivers Hospital, Sawbridgeworth — with VELYS robotic-assisted surgery available from July 2026.

• Online booking

• Telephone: 01279 602675

One of the most common concerns Mr Dennis Kosuge hears from active patients considering knee replacement is: "Will I be able to return to the activities I love?" It is a completely reasonable question — and the honest answer is that for most patients, the answer is yes, with some caveats.

Mr Kosuge performs knee replacement surgery at The Rivers Hospital, Sawbridgeworth, and takes a thorough, patient-centred approach to discussing activity goals before any operation. Here is what the evidence — and his experience — suggests.

Why does activity matter in the conversation about surgery?

The decision to have a knee replacement should always account for your lifestyle goals, not just your pain score. An active 58-year-old who wants to return to tennis has different priorities from a 75-year-old whose main goal is to walk to the shops without pain. Mr Kosuge tailors his recommendations accordingly.

Which activities are generally safe after knee replacement?

Research and registry data support return to a wide range of low-to-moderate impact activities after total or partial knee replacement. Activities generally considered compatible with knee replacement include:

• Cycling — both outdoor and stationary; excellent for rehabilitation and long-term fitness

• Swimming — a very joint-friendly activity strongly recommended post-surgery

• Walking — most patients walk significantly more comfortably than before surgery

• Golf — most patients return to golf within 3 to 6 months

• Doubles tennis — generally considered acceptable, though not universally recommended

• Yoga and Pilates — generally well tolerated with appropriate modifications

Hiking on even terrain — achievable for most patients by 6 to 12 months

Which activities carry more risk?

High-impact activities place greater stress on the implant and may accelerate wear. Mr Kosuge discusses the following activities individually with patients:

• Running — not routinely recommended after total knee replacement, though some surgeons permit jogging in younger patients with partial replacement

• Singles tennis and squash — unpredictable pivoting loads are a concern

• Skiing — possible but requires careful discussion, particularly regarding falls risk

• Contact sports — generally not advised

What does the timeline look like?

Recovery varies by individual, but as a general guide:

• 6 weeks — gentle cycling on a stationary bike, swimming (once the wound is fully healed)

• 3 months — most patients return to golf, walking for leisure, light cycling outdoors

• 6 months — most low-impact activities fully resumed; continuing to improve

• 12 months — full recovery; maximum function usually achieved

Does partial knee replacement give better results for active patients?

For patients with single-compartment arthritis who are suitable candidates, partial knee replacement tends to give a more natural knee feel and may permit a slightly broader range of activity. Mr Kosuge will discuss whether you are a candidate for partial replacement at your consultation.

Mr Kosuge's approach

"I want my patients to have realistic expectations — but I also do not want them to write off activities they love unnecessarily," Mr Kosuge says. "Modern knee replacement, when performed well and in the right patient, can allow a genuinely active lifestyle. My goal is always to get patients back to the activities that matter to them."

Mr Kosuge's patient outcomes are monitored Amplitude Clinical and are consistently above the national average for both function and patient satisfaction.

Ready to take the next step?

Mr Kosuge offers private consultations at The Rivers Hospital, Sawbridgeworth and NHS consultations at The Princess Alexandra Hospital NHS Trust, Harlow.

To book an appointment with Mr Kosuge:

• Online booking

• Telephone: 01279 602675