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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.

A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a navigated knee replacement costs in London.

Indicative ranges across UK private providers.

In short

£14,000–£19,000, home in two to four nights.

Procedure Indicative range
Computer-assisted navigation TKR (unilateral) £14,000–£19,000
Conventional jig-based TKR £12,500–£16,500
Patient-specific instrumentation (PSI) TKR £13,500–£17,500
Robotic TKR (MAKO / ROSA / CORI) £16,500–£22,000
Bilateral navigated TKR (staged) £26,000–£36,000
Consultant knee consultation only £250–£450

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.

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.

  • Not sure it is time yet?

    Injections, weight loss and physiotherapy may buy you years. We say so before you agree to surgery.

  • Confused by navigation vs robot?

    Navigation, PSI, MAKO, ROSA, CORI - the marketing is loud. An impartial surgeon-led opinion is not.

  • Want it done properly?

    A named fellowship-trained knee surgeon, a proper arthroplasty theatre team, and an enhanced-recovery pathway.

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.

  • 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.

  • Rheumatoid and inflammatory arthritis

    Advanced RA or seronegative arthritis of the knee where medical treatment has failed and joint destruction is significant.

  • Post-traumatic arthritis

    Arthritis after a previous tibial plateau, femoral condyle or patellar fracture - where anatomy is distorted and landmarks are unreliable.

  • 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.

  • Malunion or previous osteotomy

    A femur or tibia with a previous fracture, malunion, or high tibial osteotomy where intramedullary jigs cannot be used safely.

  • Retained hardware in the femur or tibia

    Old plates, nails or screws that block the standard intramedullary alignment rod - navigation avoids the canal altogether.

  • Bilateral disease with alignment concern

    Both knees affected with alignment issues - precise, reproducible cuts matter across two operations.

  • 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.

  • 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.

  • Conventional jig-based TKR

    Standard intramedullary and extramedullary jigs. Well proven, quicker in theatre, and appropriate for most straightforward knees.

  • Patient-specific instrumentation

    Custom cutting blocks made from a preop MRI or CT. Tailored to your anatomy without intra-operative navigation.

  • Robotic TKR (MAKO)

    CT-based planning with a haptic-arm robot that constrains the saw to the planned bone cuts. Longer preop imaging path.

  • Robotic TKR (ROSA)

    Image-free or X-ray-based robotic assistance from Zimmer Biomet. Sits between navigation and full CT-based robotics.

  • Robotic TKR (CORI)

    Handheld robotic burr from Smith+Nephew. Compact platform, no pre-op CT required.

  • Unilateral (single-knee) TKR

    One knee at a time - the standard approach, spreading rehabilitation load and anaesthetic risk.

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.

  • 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.

  • 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.

  • 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.

  • Patellar issues and maltracking

    Anterior knee pain, patellar maltracking or clunking can occur. Careful component rotation - where navigation can help - reduces the risk.

  • Instability and aseptic loosening

    A knee that feels unstable, or components that loosen over years, may need revision. Registry data guides implant choice.

  • Periprosthetic fracture

    A fracture around the implant, usually after a fall, may need internal fixation or revision surgery.

  • 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.

  • Extended tourniquet time

    Navigation adds a few minutes of setup and registration. Modern practice minimises tourniquet time and its risks.

  • 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 UK consultant knee surgeon reviewing a patient’s operation notes

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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover for total knee replacement is typically funded by major UK insurers when medically indicated.

Frequently asked

Everything we get asked about navigated knee replacement.

Quick answers on evidence, cost, alternatives, and recovery.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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.

  • 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?

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 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.