Concierge knee surgery · London
Computer-assisted navigation knee replacement, by a fellowship-trained knee surgeon.
A total knee replacement with intra-operative navigation — trackers on the femur and tibia, alignment and gap balancing computed live, and honest advice on when a conventional jig or a robotic system would suit you better.
Why patients choose us
- 01
A fellowship-trained knee surgeon with navigation experience
Not a general orthopaedic list. A named consultant who uses navigation regularly, in a proper theatre with a dedicated implant team.
- 02
Navigation, robotic and conventional weighed honestly
For some knees a conventional jig is fine, for others navigation or a robot earns its keep. We say which one, and why, before you commit.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a navigated knee replacement costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A navigated TKR in our network: £14,000–£19,000, home in two to four nights.
| Procedure | Indicative range | Typical theatre time | Hospital stay |
|---|---|---|---|
| Computer-assisted navigation TKR (unilateral) | £14,000–£19,000 | 60–90 min | 2–4 nights |
| Conventional jig-based TKR | £12,500–£16,500 | 60–90 min | 2–4 nights |
| Patient-specific instrumentation (PSI) TKR | £13,500–£17,500 | 60–90 min | 2–4 nights |
| Robotic TKR (MAKO / ROSA / CORI) | £16,500–£22,000 | 75–110 min | 2–4 nights |
| Bilateral navigated TKR (staged) | £26,000–£36,000 | Two admissions | Staged 3–6 months |
| Consultant knee consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by implant brand, by the technology used (navigation, PSI or robotic), and by any additional work at the same admission. We come back with a firm quote within one working day.
The problem
The right surgeon, the right technology, the right implant.
Total knee replacement is one of the most successful operations in medicine — and one where technology (navigation, PSI, robotics) is oversold. We help you see what actually earns its keep for your knee.
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Not sure it is time yet?
Injections, weight loss and physiotherapy may buy you years. We say so before you agree to surgery.
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Confused by navigation vs robot?
Navigation, PSI, MAKO, ROSA, CORI — the marketing is loud. An impartial surgeon-led opinion is not.
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Want it done properly?
A named fellowship-trained knee surgeon, a proper arthroplasty theatre team, and an enhanced-recovery pathway.
The journey
From enquiry to full rehab — what happens, in order.
One clinician from first message to six-week review, with a structured physiotherapy pathway running alongside.
Phase 1 · Before your surgery
Imaging and preop optimisation
Phase 2 · On the day
Theatre and enhanced recovery
Phase 3 · After
Rehab and review
- 01
Before
You tell us what is going on
A short, confidential form. Symptoms, previous imaging, deformity, any previous fracture, and how the knee limits your day.
- 02
Before
Imaging and long-leg radiographs
Weight-bearing long-leg alignment films and standard knee views — the surgeon plans the mechanical axis and implant sizing from these.
- 03
Before
Preop optimisation
Weight loss where relevant, smoking cessation, dental review, and a medical work-up. Blood-thinners are reviewed with the team, never stopped without advice.
- 04
On the day
Arrival at the hospital
Admission, consent, and a chat with the surgeon and anaesthetist. Spinal or GA, with a regional block for post-op pain.
- 05
On the day
Surgery with intra-operative navigation
Tracker arrays are fixed to the femur and tibia, the anatomy is registered, and the cuts and gap balancing are computed live. 60 to 90 minutes in theatre.
- 06
On the day
Enhanced recovery from day one
Standing and walking the same day where possible, tailored analgesia, and DVT prophylaxis started on schedule. Day-case discharge is increasingly feasible in selected patients.
- 07
After
Rehabilitation and review
Structured physiotherapy from week one. Most patients drive by six weeks and return to low-impact activity by three months. A surgeon review is arranged at six weeks.
Typical end-to-end: 4–8 weeks from enquiry to surgery. Structured rehab: 3–6 months.
When it helps
When navigation earns its keep in a knee replacement.
The situations where navigation genuinely helps, plus the one red flag that means an emergency rather than an appointment.
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Severe end-stage osteoarthritis
Bone-on-bone knee OA with pain, stiffness and loss of function that has not responded to physiotherapy, injections or lifestyle change.
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Rheumatoid and inflammatory arthritis
Advanced RA or seronegative arthritis of the knee where medical treatment has failed and joint destruction is significant.
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Post-traumatic arthritis
Arthritis after a previous tibial plateau, femoral condyle or patellar fracture — where anatomy is distorted and landmarks are unreliable.
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Significant varus or valgus deformity
A markedly bow-legged or knock-kneed alignment where restoring the mechanical axis by eye is difficult — navigation shines here.
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Malunion or previous osteotomy
A femur or tibia with a previous fracture, malunion, or high tibial osteotomy where intramedullary jigs cannot be used safely.
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Retained hardware in the femur or tibia
Old plates, nails or screws that block the standard intramedullary alignment rod — navigation avoids the canal altogether.
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Bilateral disease with alignment concern
Both knees affected with alignment issues — precise, reproducible cuts matter across two operations.
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Red flag: hot swollen knee with fever
A hot, swollen, painful knee with fever after any knee surgery is a possible joint infection — same-day A&E, not a clinic booking.
Procedure options
Navigation is one option among several.
What each technique on the table actually involves — and which fits which knee.
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Computer-assisted navigation TKR
Optical trackers fixed to femur and tibia; instruments tracked in real time; alignment and gap balancing computed live. No pre-op CT needed.
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Conventional jig-based TKR
Standard intramedullary and extramedullary jigs. Well proven, quicker in theatre, and appropriate for most straightforward knees.
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Patient-specific instrumentation
Custom cutting blocks made from a preop MRI or CT. Tailored to your anatomy without intra-operative navigation.
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Robotic TKR (MAKO)
CT-based planning with a haptic-arm robot that constrains the saw to the planned bone cuts. Longer preop imaging path.
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Robotic TKR (ROSA)
Image-free or X-ray-based robotic assistance from Zimmer Biomet. Sits between navigation and full CT-based robotics.
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Robotic TKR (CORI)
Handheld robotic burr from Smith+Nephew. Compact platform, no pre-op CT required.
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Unilateral (single-knee) TKR
One knee at a time — the standard approach, spreading rehabilitation load and anaesthetic risk.
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Consultation only
An honest discussion of whether joint replacement is needed yet, and which technique fits your knee — no obligation.
Our vetted London network
A small panel of knee surgeons, we picked them.
Fellowship-trained consultant knee surgeons across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your knee.
Selection criteria
How we choose every knee surgeon in our network.
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Consultant knee surgeons with fellowship training and regular navigation practice
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Full range of techniques offered — conventional, navigation, PSI and robotic
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Dedicated arthroplasty theatre teams and enhanced recovery pathways
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National Joint Registry submission and audited revision rates
Safety and recovery
What can go wrong, and what we plan around.
Total knee replacement is a big, successful operation with real risks. The things worth planning are infection, clots, stiffness, and knowing what warrants a same-day call.
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Infection is the complication we plan around most
Superficial wound infection is uncommon; deep periprosthetic joint infection (PJI) is rare but serious. Antibiotic prophylaxis, laminar-flow theatre and strict wound care all matter.
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DVT and PE prophylaxis for weeks, not days
Blood-thinning medication, early mobilisation and mechanical devices reduce clot risk. The regime continues for several weeks after discharge.
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Stiffness and manipulation under anaesthetic
A small number of patients develop stiffness (arthrofibrosis). If flexion has not improved by six to twelve weeks, a manipulation under anaesthetic (MUA) may be discussed.
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Patellar issues and maltracking
Anterior knee pain, patellar maltracking or clunking can occur. Careful component rotation — where navigation can help — reduces the risk.
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Instability and aseptic loosening
A knee that feels unstable, or components that loosen over years, may need revision. Registry data guides implant choice.
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Periprosthetic fracture
A fracture around the implant, usually after a fall, may need internal fixation or revision surgery.
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Tracker pin-site issues
Navigation uses small pins in the femur and tibia to hold the trackers. Pin-site infection or, rarely, fracture through the pin site can occur.
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Extended tourniquet time
Navigation adds a few minutes of setup and registration. Modern practice minimises tourniquet time and its risks.
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Red flags after discharge
Fever, spreading redness, a hot swollen calf, sudden shortness of breath, chest pain, or a fall onto the operated knee — all reasons to seek same-day medical help.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technology was used, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and implant chosen
Why the procedure was done — end-stage OA, RA, post-traumatic arthritis — and which implant system, size and bearing were used.
- 02 Technique
Anaesthetic and navigation technique
Whether it was done under spinal or GA, which navigation platform was used, and the planned versus achieved alignment recorded by the system.
- 03 Findings
Alignment, gap balance and soft tissues
The mechanical axis, coronal and sagittal alignment, flexion and extension gaps, and any soft-tissue releases performed.
- 04 Impression
Recovery, rehab plan and review timing
Read this first: weight-bearing status, DVT prophylaxis regime, expected rehabilitation milestones, and when the surgeon and physiotherapist will see you.
Recognised by major UK insurers
Cover for total knee replacement is typically funded by major UK insurers when medically indicated. Technology upcharges (navigation, PSI, robotic) vary by policy — we confirm cover before booking.
Frequently asked
Everything we get asked about navigated knee replacement.
Quick answers on evidence, cost, alternatives, and recovery.
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What is computer-assisted navigation total knee replacement (CAS-TKR)?
A total knee replacement where infrared or optical trackers are fixed to the femur and tibia during surgery. The instruments are tracked in real time, and the system calculates the bone cuts, implant position and ligament balance live — so the surgeon can adjust before making the definitive cuts.
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How is navigation different from a robotic knee replacement?
Navigation gives the surgeon live measurement and feedback but they still make the cuts freehand with tracked instruments. Robotic systems (MAKO, ROSA, CORI) add a physical constraint — a haptic arm or burr — that limits the saw or burr to the planned bone cuts.
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Is a navigated knee replacement better than a conventional one?
The evidence shows navigation produces more consistent mechanical alignment and a lower rate of alignment outliers. Whether that translates into better long-term function and implant survival is still debated — most studies show similar patient-reported outcomes at five to ten years.
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How much does a private CAS-TKR cost in London?
Roughly £14,000–£19,000 for a navigated unilateral TKR in our network, compared to £12,500–£16,500 for conventional and £16,500–£22,000 for full robotic. We confirm a firm figure across two or three options within one working day.
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What is the recovery like after a navigated knee replacement?
Most patients stand and walk on the day of surgery, go home after two to four nights, and are off crutches by two to four weeks. Driving usually returns by six weeks, and low-impact activity by three months. Full recovery continues for a year.
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Am I too young or too old for a knee replacement?
There is no strict age cut-off. The decision balances symptoms, function, imaging, medical fitness and expected implant longevity. Fitter older patients do well; younger patients need a careful discussion about implant survival over decades.
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What are the main risks?
Infection (superficial and rare periprosthetic joint infection), DVT and PE, stiffness that may need manipulation, patellar maltracking, instability, aseptic loosening, periprosthetic fracture and, specific to navigation, small risks at the tracker pin sites.
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Is day-case knee replacement really possible?
Yes, for a carefully selected group — fit, motivated patients with good support at home, spinal anaesthetic, a slick enhanced-recovery pathway and a surgeon who does it regularly. Most patients in the UK still stay one to three nights.
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When should I seek urgent help after surgery?
Fever, a hot spreading red area on the wound, wound discharge, a hot swollen calf, sudden breathlessness or chest pain, a fall onto the operated knee, or new sudden severe pain — all are reasons for same-day A&E or a call to the surgical team.
Related tests
Looking for something else?
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Knee arthroscopy
Keyhole knee surgery for cartilage and meniscal problems.
Learn more -
Musculoskeletal MRI
Detailed MRI imaging of joints, ligaments and cartilage.
Learn more -
X-ray
Long-leg alignment and weight-bearing knee radiographs.
Learn more -
All tests
Every test and procedure we arrange.
Learn more -
Osteoarthritis Hip Knee
Related condition guide.
Learn more -
Plantar Fasciitis
Related condition guide.
Learn more
In practice, in London
Booking computer assisted navigation total knee replacement privately in London — what actually happens
For computer assisted navigation total knee replacement, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Public provision for computer assisted navigation total knee replacement is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.
A private computer assisted navigation total knee replacement pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For computer assisted navigation total knee replacement in particular, we bias towards consultants who do this every week rather than every month.
The value of going through a concierge for computer assisted navigation total knee replacement isn’t access — anyone with an insurer or a credit card can get a private appointment in London. The value is knowing which consultant reads this particular presentation best, which unit turns reports around fastest, and which pathway won’t hit a dead end if the findings point somewhere unexpected.