Robotic Knee Replacement Surgery in NYC
Robotic-assisted knee replacement is an advanced surgical approach that uses computer guidance and robotic technology to enhance the precision of knee resurfacing and replacement — giving the surgeon real-time, three-dimensional mapping of the patient’s unique knee anatomy to optimize implant positioning, alignment, and soft tissue balance with a level of accuracy that manual instrumentation alone cannot consistently achieve. The technology can be applied to both partial (unicompartmental) knee replacement — where only the damaged compartment of the knee is resurfaced while preserving the healthy bone, cartilage, and ligaments — and total knee replacement, where all three compartments are replaced. Because robotic guidance allows the surgeon to work through a smaller incision with greater precision, patients typically experience less blood loss, less post-operative pain, faster recovery, and a more natural-feeling knee than with conventional replacement techniques. If you are considering your knee surgery options, robotic-assisted replacement represents the current state of the art for patients with arthritis that has progressed beyond the point where conservative treatment and joint-preservation procedures can provide adequate relief.
Dr. Jonathan Glashow is a board-certified orthopedic surgeon and Clinical Associate Professor of Orthopedic Surgery at NYU Grossman School of Medicine, with over 30 years of experience treating knee arthritis across the full spectrum — from biologic therapies and joint-preservation procedures in earlier stages to robotic-assisted partial and total knee replacement for advanced disease. What distinguishes Dr. Glashow’s approach to knee replacement is that he is not exclusively a replacement surgeon — his extensive background in arthroscopic surgery, cartilage restoration, osteotomy, and biologic therapies means that he has personally exhausted the non-replacement options with many of his patients before recommending a joint replacement, giving him a comprehensive understanding of which patients will benefit most from robotic replacement and which may still be candidates for joint-preserving alternatives. Working with professional athletes has shaped how he approaches knee replacement in every patient. The benchmark is not whether you can climb stairs or walk a flat mile, it is whether you can get back to the court, the trail, or the course. Dr. Glashow serves in senior medical roles with the New Jersey Devils, Philadelphia 76ers, and Washington Commanders, and has been named a Castle Connolly Top Doctor every year since 2000. He performs robotic knee replacement surgeries exclusively here in Manhattan.
Benefits of Robotic Knee Replacement Surgery
- Implant position planned against your anatomy before surgery begins
- Real-time feedback that holds each cut inside the plan
- More consistent alignment and soft tissue balance
- Smaller incision and less soft tissue disruption
- Most patients go home the same day
Dr. Glashow uses the Stryker Mako system for robotic knee replacement procedures here in NYC. Before surgery, a CT scan builds a three-dimensional model of your knee, and the implant position is planned against your specific anatomy rather than standard sizing. During the procedure, the robotic arm holds him within that plan while he adjusts based on how the knee balances through its range of motion. He controls every cut. The system does not make decisions; it executes them within tighter margins than manual instruments allow.
That precision is what drives the rest of it. Tighter margins mean less bone removed, less soft tissue disruption, and an implant seated where it was planned to sit, which is why most robotic knee replacement patients walk the same day and go home without an overnight stay.
Partial vs. Total Knee Replacement: Which Is Right for You?
Not every arthritic knee needs a full replacement. One of the most important decisions Dr. Glashow makes with each patient is whether the damage is confined enough to resurface only part of the joint or whether arthritis has spread far enough that all three compartments need to be addressed.
A partial (unicompartmental) knee replacement resurfaces only the damaged compartment, whether medial (inner), lateral (outer), or patellofemoral (front), and leaves the healthy cartilage, bone, and both cruciate ligaments intact. Because the ACL and PCL are preserved, the knee retains much of its natural movement and proprioception, and most patients report that the joint feels more like their own. The incision is smaller and less bone is removed. That bone preservation matters long term: if the remaining compartments develop arthritis years later, conversion to a total replacement remains straightforward.
A total knee replacement resurfaces all three compartments and is the right choice when arthritis is widespread, when there is significant deformity, or when ligament stability has been compromised.
Dr. Glashow performs both partial and total knee replacements using the Stryker Mako system. He evaluates weight-bearing X-rays, MRI when indicated, and the knee’s stability and range of motion under examination to determine which approach will deliver the best long-term result. Whether the goal is tennis, golf, hiking, or simply keeping up with an active lifestyle, both partial and total knee replacement are designed to get patients back to doing what they love.
Frequently Asked Questions About Robotic Knee Replacement
Our goal for both partial and total knee replacement is to return patients to the activities they actually care about, not to a minimum functional benchmark. We use robotic-assisted planning with the Stryker Mako system, cementless implants where appropriate, and physical therapy that is integrated into the surgical plan rather than handed off. Dr. Glashow and his team stay closely involved through recovery, because the difference between an acceptable outcome and getting back to your sport is usually what happens in the months after surgery. In a traditional knee replacement, the surgeon uses manual cutting guides and handheld instruments to remove arthritic bone and position the implant. In robotic-assisted knee replacement, advanced imaging creates a three-dimensional model of the patient’s knee before surgery, and a robotic arm guided by the surgeon executes the bone cuts with sub-millimeter precision — staying within the pre-planned boundaries and adjusting in real time based on the knee’s individual anatomy. The surgeon remains in full control throughout the procedure; the robotic system enhances accuracy rather than replacing surgical judgment. The result is more consistent implant positioning, better soft tissue balance, and a more natural-feeling knee. A partial (unicompartmental) knee replacement resurfaces only the damaged compartment of the knee — medial, lateral, or patellofemoral — while preserving the healthy cartilage, bone, and ligaments in the remaining compartments. This approach involves a smaller incision, less bone removal, and typically a faster recovery than total knee replacement. A total knee replacement resurfaces all three compartments and is used when arthritis has spread throughout the entire joint. Robotic guidance is used for both procedures. Dr. Glashow evaluates each patient’s X-rays, MRI, and clinical examination to determine which approach will provide the best long-term result. The robotic system provides the surgeon with a patient-specific 3D model of the knee, real-time feedback on bone cut accuracy, and the ability to fine-tune implant positioning during surgery based on how the knee moves and balances under load. Studies show that robotic-assisted knee replacement produces more accurate implant alignment, better ligament balance, and more predictable outcomes compared to conventional manual techniques. For patients, this translates into a knee that feels more natural, better range of motion, reduced risk of implant-related complications, and potentially longer implant lifespan. Because the robotic approach is less invasive than traditional knee replacement — with a smaller incision, less soft tissue disruption, and greater precision — many patients experience a faster recovery. Most patients go home the same day as surgery and begin walking with assistance immediately. Physical therapy starts within the first few days and progresses through range of motion, strengthening, and functional training over the following weeks. Many patients return to daily activities within two to four weeks and to low-impact recreational activities within six to twelve weeks. Full recovery and maximum benefit from the implant typically occur between three and six months after surgery. Modern knee replacement implants are designed to last 20 to 25 years or longer with normal use, and the improved precision of robotic-assisted placement may extend implant lifespan further by optimizing alignment and reducing abnormal wear. Factors that influence long-term implant durability include proper implant positioning (where the robotic system excels), maintaining a healthy body weight, staying active with low-impact exercise, and avoiding high-impact activities that place excessive stress on the implant. Dr. Glashow discusses realistic longevity expectations with each patient based on their age, activity level, and knee anatomy. Age alone is not the determining factor. The decision is based on the severity of arthritis, the degree of pain and functional limitation, and whether non-surgical and joint-preserving treatments have been adequately tried. Younger patients with severe arthritis that has not responded to conservative treatment and joint-preservation procedures may benefit significantly from knee replacement — and robotic-assisted partial replacement is particularly well-suited for younger, active patients because it preserves healthy bone and ligaments. Older patients in good general health can also be excellent candidates. Dr. Glashow evaluates each patient’s individual situation and discusses all available options — including non-replacement alternatives — before recommending surgery. In practice, that range is wide: he has performed knee replacement on former professional athletes in their thirties and on patients in their eighties.
