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I don't use a robot or computer aided navigation as, in complex cases and "revisions" or re-do's, they cannot be used. This means that I am better able to cope with the more difficult cases without losing out on my normal skills.
I also do not use a tourniquet. There is no evidence that they make a big difference to blood loss during a patient's stay in hospital and by not using one the risks associated with their use (nerve damage, muscle damage and pain after surgery) are avoided.
I usually cut the skin on the outer side of the knee rather than straight over the knee. This has been shown to improve feeling over the front of the knee after surgery and can improve the comfort when trying to kneel after surgery.
As I have an interest in re-do, "revision" surgery, I usually put in the new knee (or hip) without cement. This leaves more of the patient's own bone behind should they ever need further surgery in the future.
Finally, I usually leave the knee cap alone. Again, this preserves the patient's own bone, making it easier to perform re-do, "revision" surgery in the future.
As in all aspects of life, there will be exceptions to the advice given above for hips and knees. It is only a guide. This variation would simply represent a recognition that you, as a patient, are a unique individual who will need surgery tailored to their specific needs and wishes.
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