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Orthopaedics · UK

ROSA knee replacement - imageless robotic precision.

Robotic-assisted total and partial knee replacement on the Zimmer Biomet ROSA platform. A named ROSA-certified consultant, standing long-leg planning, and every alignment number recorded and reviewed with you.

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

Indicative pricing

What a private ROSA knee replacement costs in the UK.

Indicative ranges across our partner orthopaedic units.

In short

£16,000–£22,000, home in 1–2 nights.

ProcedureIndicative range
ROSA robotic-assisted total knee replacement£16,000–£22,000
ROSA robotic-assisted partial knee replacement£15,000–£20,000
Standard (non-robotic) total knee replacement£12,500–£17,000
Revision ROSA-assisted TKR£20,000–£30,000
Bilateral ROSA TKR (staged)£30,000–£40,000
Consultant knee opinion£250–£400

Prices vary by hospital, consultant, implant choice (cemented, cementless, ultracongruent) and whether a patellar button is added. Bilateral staged operations are two admissions with two invoices.

The problem

Robot on the box, planning off the table.

Robotic knee replacement is only as good as the planning that precedes it. Standing long-leg X-rays, alignment target and ligament philosophy - decided before you enter theatre.

  • Standing long-leg X-rays, always

    Weight-bearing views show the true mechanical axis. Short films miss half the story.

  • Kinematic or mechanical?

    Two respected alignment philosophies. The right one for you depends on your deformity and expectations - decided pre-op.

  • Implant matters too

    ROSA sits with Persona, Vanguard or NexGen.

When it helps

Who ROSA suits best.

The situations where robotic-assisted knees change outcomes, plus the red flag that means ROSA is not the right tool.

  • End-stage medial or tricompartmental arthritis

    Bone-on-bone changes on standing X-rays with pain limiting walking, sleep and stairs - when conservative treatment has run out.

  • Varus or valgus deformity

    ROSA’s intra-operative gap graph is at its best when correcting mechanical axis without over-releasing soft tissues.

  • Stiff, poorly balanced previous knee replacement

    For selected revision cases where a robotic-assisted alignment reset gives a cleaner second attempt at balance.

  • Younger, higher-demand patients

    ROSA suits patients in their 50s and 60s who want a precise, ligament-balanced knee that will last decades.

  • Post-traumatic knee arthritis

    Where previous fractures have altered anatomy - ROSA’s live registration adapts to unusual bone landmarks.

  • Patients who value data-led decisions

    Every cut, gap and alignment number is recorded and reviewed with you at follow-up.

  • Bilateral disease planned in stages

    Two knees, three months apart - ROSA gives repeatable alignment on both sides.

  • Red flag: active septic joint or severe bone loss

    Active infection or major bone deficit changes the operation - ROSA is not the right tool and revision or two-stage surgery is planned instead.

Procedure options

ROSA is one of several ways to do a knee.

Where ROSA fits alongside Mako, Cori, computer-assisted navigation and standard manual instruments.

  • ROSA Knee (Zimmer Biomet)

    Imageless robotic arm - no pre-op CT. Uses infrared trackers and intra-operative registration. Paired with Persona, Vanguard or NexGen implants.

  • ROSA Partial Knee

    For isolated medial or lateral compartment disease. Ligament-preserving, quicker recovery, but strict selection criteria.

  • ROSA Hip (companion platform)

    The hip variant of the same ecosystem - covered on our robotic orthopaedic surgery page.

  • Mako Total Knee (Stryker)

    CT-based robotic-arm system - the market alternative to ROSA. Different workflow, similar outcomes in good hands.

  • CORI Knee (Smith & Nephew)

    Handheld robotic burr, imageless, compact. See the Cori-specific page for detail.

  • Computer-assisted navigation

    Navigation without a robotic arm - a mature technology, sometimes preferred in high-BMI patients.

  • Standard manual TKR

    The workhorse operation with 90–95 percent survivorship at 15 years. Robotic advantages are precision, not necessarily longevity.

  • ROSA-assisted revision

    Selected revision cases benefit from ROSA’s alignment tools - but complex bone loss still needs specialist revision technique.

Safety and recovery

What to expect afterwards - honestly.

Knee replacement is a decade-defining operation. The things worth planning are pre-hab, physio, and realistic sport goals.

  • Anaesthetic - usually spinal

    A spinal with light sedation is standard, and lets you eat and mobilise sooner than GA. GA is used if you prefer.

  • Blood loss and transfusion

    Tranexamic acid brings transfusion rates below 2 percent. A drain is rarely needed.

  • Infection

    Deep prosthetic joint infection risk is 0.5–1 percent, treated with strict prophylaxis, laminar-flow theatre and screening.

  • DVT and PE

    Chemical prophylaxis for 2–6 weeks depending on risk, plus stockings and early mobilisation. Same-day team for calf pain or breathlessness.

  • Stiffness and manipulation under anaesthetic

    Fewer than 5 percent of patients need MUA. Aggressive early physio is the best insurance.

  • Tracker pin sites

    ROSA uses percutaneous pins for the femur and tibia. Pin-site fracture is exceedingly rare with the recommended techniques.

  • Nerve or vascular injury

    Peroneal nerve palsy risk under 1 percent, higher in severe valgus correction. Careful surgery and post-op posture prevent most cases.

  • Return to activity

    Walking with sticks day one, off crutches by 2–4 weeks, driving 4–6 weeks, golf 8–12 weeks, doubles tennis 3–6 months, cycling 6 weeks.

  • Red flags after surgery

    Fever, spreading redness, wound discharge, calf swelling, sudden breathlessness or severe pain: same-day team or A&E.

Reading your operation note

Your operation note in four parts. Read the last one first.

ROSA prints a personalised operative report with the recorded alignment and gap data - keep it with your notes.

A UK consultant orthopaedic surgeon reviewing ROSA data

A quiet reminder

Alignment numbers can look intimidating - we translate them for you.

If you would like us to walk you through the ROSA report before your six-week review, just ask.

  1. 01Header

    Implant and system used

    The exact implant (Persona, Vanguard), sizes, ROSA system version, and whether cemented or cementless.

  2. 02Technique

    Registration, cuts and alignment

    Mechanical or kinematic alignment target, ROSA’s planned versus achieved angles, and any intra-operative changes.

  3. 03Findings

    Gaps and balance

    ROSA’s recorded gap graph - flexion and extension gaps in medial and lateral compartments - plus any soft-tissue release.

  4. 04Impression

    Rehab plan and follow-up

    Read this first: weight-bearing status, DVT prophylaxis, physio schedule, follow-up X-ray timing.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Robotic knee replacement is now covered by most UK insurers for approved indications.

Frequently asked

Everything we get asked about ROSA knees.

Quick answers on ROSA vs Mako, alignment, cost, cover and recovery.

  • What is ROSA and how is it different from Mako?

    ROSA (Zimmer Biomet) is an imageless robotic arm - no pre-operative CT is needed. The surgeon builds your personalised plan on the table using live registration. Mako (Stryker) is CT-based - a pre-op scan drives a haptic robotic arm. In experienced hands, published outcomes and alignment accuracy are broadly comparable; the surgeon and implant choice matter more than the platform.

  • Does ROSA cut with the robot?

    No. ROSA holds the cutting guide precisely in the planned position - the surgeon still makes every cut with a standard saw. The robot is a very steady guide, not an autonomous cutter.

  • Is ROSA more accurate than a normal knee replacement?

    For component alignment and ligament balance, yes - most studies show ROSA and other robotic-assisted systems hit target alignment more consistently than manual instrumentation. Whether that translates to a longer-lasting knee is still being followed up on the National Joint Registry; early data are encouraging.

  • How much does a ROSA knee replacement cost in the UK?

    Roughly £16,000–£22,000 for a ROSA total knee, £15,000–£20,000 for a ROSA partial knee, and £20,000–£30,000 for a ROSA-assisted revision. Standard non-robotic TKR runs £12,500–£17,000.

  • How long is recovery after a ROSA knee?

    Similar to any modern enhanced-recovery TKR. Walking with sticks on day one, home in 1–2 nights, off crutches at 2–4 weeks, driving 4–6 weeks, golf 8–12 weeks. Full recovery - the last of the swelling and the best of the flexion - usually settles by 9–12 months.

  • Can I have both knees done with ROSA?

    Yes, but almost always staged. Doing both at one sitting doubles blood loss, DVT and cardiac risk. We prefer three months between operations so the first knee is strong before the second - with the same ROSA-trained consultant both times.

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