Robotic-assisted knee surgery offers new lease of mobility for patients

For 59-year-old Christine Musonye, the journey to understanding her own body has been one of persistence and long-delayed answers. For about six years, she has battled arthritis, a common, often chronic condition marked by joint inflammation, pain, and stiffness caused by cartilage wear or immune system attacks.

Musonye recalls the first signs of trouble appearing around 2019. What began as intermittent pain in the sole of her right foot eventually spread to her knee, evolving into a debilitating condition that robbed her of her mobility.

"I would feel sharp pain in the soles of my feet. But as time went on, the pain grew sharper and spread through my foot. It continued to intensify until I was completely immobilised,” she said.

In the early years, the severity of her condition was masked by temporary fixes. Like many navigating chronic pain without a clear diagnosis, she frequented local chemists for over-the-counter medication. At the time, she didn't realise that the relief she felt was only temporarly veil over a chronic condition.

Also read: My knee is clicking. Am I getting arthritis?

It was three years later, at a Nairobi hospital, that she was finally diagnosed with arthritis and underwent her first surgery.

“The aftermath of the surgery was painful, and it took me about two months before I could comfortably walk again,” says Musonye.

The surgery bought her three years of mobility before the disease struck again in 2025, this time in her right leg. Musonye packed her bags once more and travelled to Nairobi for treatment. There, she would become one of the first two patients to undergo robotic-assisted knee replacement surgery at Metropolitan Hospital in December. The procedure, 
which resurfaces damaged knee joints by replacing diseased bone and cartilage with implants, is designed to alleviate chronic pain and restore mobility.

At the hospital, she was informed about the newly available technology and given the opportunity to try it. Robot-assisted knee replacement surgery is an advanced, computer-guided technique in which orthopaedic surgeons use a robotic arm to perform highly precise total or partial knee replacements. The technology is the first of its kind in East and Central Africa, marking a significant milestone for orthopaedic care in the region.

“When I first arrived, I was very anxious about going through with it. I was afraid it would make mistakes and harm me. I believed I was safe with a doctor,someone who could assess the situation and make sound decisions. It took my relatives’ intervention to get me to agree,” she says.

“I was able to walk the same day after surgery, and I have been pain-free to date. I underwent my first review at the beginning of the year and was given a clean bill of health. I’m due for another review in three months to check my progress, but I am recovering well,” she adds

Musonye is among a growing number of older adults experiencing bone and joint conditions that increasingly affect mobility and quality of life. The most common of these is osteoarthritis, a degenerative condition caused by the gradual wear and tear of joint surfaces over time. It particularly affects weight-bearing joints such as the knees, leading to pain, stiffness, deformities like bowed legs or knock knees, and, in advanced cases, the need for joint replacement surgery.

Joint disease

Many elderly patients also contend with degenerative joint disease, where cartilage deterioration is accelerated by age, previous injuries, or prior surgeries. Long-standing joint damage can alter normal limb alignment and severely restrict movement. Spinal degeneration is also common with advancing age, often resulting in chronic back pain, nerve compression, and functional impairment that may eventually require surgical intervention.

Another major concern among older adults is osteoporosis, a condition marked by reduced bone density and strength. Weak, porous bones increase the risk of fractures, sometimes from minor falls or even routine movement, and can complicate surgical care. Elderly patients may also suffer from rheumatoid arthritis, an inflammatory autoimmune disease that can worsen joint pain, prolong recovery, and diminish surgical outcomes.

Previous infections, old fractures, or prior surgeries can further damage joints and bone structure, leaving defects that impair mobility and limit treatment options later in life. Together, these conditions account for a significant proportion of bone and joint disorders in the elderly and are a leading cause of chronic pain, disability, and loss of independence.

The hospital’s head of Robotics, Joint Replacement, and Spine Surgery, Dr Faraj Alkizim, said the technology of robot-assisted knee surgery represents a significant leap forward in surgical precision, safety, and patient outcomes.

“We are living in an era of artificial intelligence and precision medicine. The question is no longer whether we can do surgery well, but whether we can do it better,” said Dr Alkizim.

Contrary to common belief, knee replacement surgery does not involve replacing the entire knee. According to Dr Alkizim, only the damaged surfaces of the joint are replaced.

“The knee is a major weight-bearing joint. Over time, or due to injury or disease such as arthritis, the smooth surface wears out and becomes rough and deformed. We replace that damaged part with a prosthetic joint, almost like placing a cap over the worn surface,” he explained.

Robotic-assisted surgery enhances this process by using advanced imaging, artificial intelligence, and computer-guided precision to plan and execute bone cuts, which is the most critical part of the operation.

Before surgery, patients undergoing robotic knee replacement undergo a CT scan from hip to foot. The scan enables surgeons to assess the full alignment of the limb and develop a detailed, patient-specific surgical plan.
“We virtually perform the surgery on a computer before the patient ever enters the theater. We determine exactly where to cut, how deep, and at what angle, down to sub-millimetre and sub-degree accuracy. Every robotic procedure includes a full back-up plan. If the robot fails for any reason, we immediately switch to conventional surgery. The patient is never put at risk,” said Dr Alkizim.

“On the day of surgery, the surgeon exposes the knee joint as usual. The robotic system then executes the pre-planned bone cuts within strict safety boundaries, ensuring only bone is cut and surrounding tissues are protected. The surgeon then places the implant and completes the procedure. The robot does not replace the surgeon; it assists the surgeon by improving accuracy and reducing human error,” emphasised Dr Alkizim.

Also read: Osteoarthritis: It’s not just old age

Dr Alkizim said robotic-assisted surgery offers several advantages over conventional knee replacement, including improved precision, better alignment, increased predictability of outcomes, and enhanced safety.

“Freehand bone cutting carries a higher risk of unintended injury. The robot operates within a controlled boundary, which reduces the risk of damage to surrounding structures,” he said.

Dr Alkizim explains that most patients who qualify for knee replacement surgery are also suitable for robotic-assisted procedures. However, certain cases such as severe deformities, previous infections, major bone defects, or advanced osteoporosis may still require conventional surgery.

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