Leading orthopaedic surgeons from NHS Golden Jubilee, one of Europe’s premier arthroplasty centres, in collaboration with tactile sensor specialist PPS, will present groundbreaking research at the Personalized Arthroplasty Society (PAS) Conference in Rome on 15th–16th September 2025. The study introduces the first in vivo trial of the PPS Precision Knee Aligner (PKA) system, a cutting-edge technology designed to enhance the precision of knee replacement surgery by combining pressure sensor measurements with real-time data to balance soft tissues effectively.

Total knee replacement, a complex procedure, relies heavily on achieving accurate soft tissue balance to ensure long-term success. Historically, this process has been subjective, with surgeons depending on manual perception, tensor devices, and gap gauges, which often lead to inconsistent outcomes. While robotic systems like the ROSA and Mako robots, used extensively at NHS Golden Jubilee since November 2019, have improved implant positioning, achieving reliable soft tissue balance has remained a challenge. The PKA system addresses this by providing real-time measurements of tibiofemoral force and load distribution, enabling surgeons to monitor how each surgical step, such as patella positioning, impacts joint stability.

Key features of the PKA system

• Real-time data. Provides live feedback on tibiofemoral forces, allowing precise adjustments during surgery.
• Enhanced precision. Measures load distribution between knee compartments, reducing guesswork in soft tissue balancing.
• Improved outcomes. Aims to lower the postoperative dissatisfaction rate, currently affecting up to 20% of patients.

“By visualising the internal load distribution between compartments, surgeons can make more informed decisions that may reduce the high rate of postoperative dissatisfaction currently affecting up to one in five patients,” said Dr Andrew Brunt, Orthopaedic Surgical Registrar at NHS Golden Jubilee.

The collaboration between NHS Golden Jubilee and PPS has been instrumental in developing this technology. Alistair Lawley, AI and Machine Intelligence Researcher at PPS, stated: “We’ve collaborated closely with the team at NHS Golden Jubilee to co-develop this technology to help improve comfort and fit of knee implants, benefiting from their exceptional surgical expertise and research leadership to transform how knee replacements are performed and experienced in the future.”

The research team conducted cadaver trials to validate the PKA system’s capacitance sensors, confirming their ability to accurately measure knee forces under standardised conditions. These trials mark a significant step toward the first in-human trials, with potential for commercial adoption. NHS Golden Jubilee, which performs over 30% of Scotland’s elective hip and knee replacements, is a leader in robotic-assisted surgery, having completed over 3,000 Mako procedures and more than 100 ROSA robotic knee replacements, the second-highest in the UK.

Impact of this technology extends beyond surgery

• Patient recovery. Enhanced precision may lead to shorter hospital stays and faster recovery times.
• NHS efficiency. Reduced need for revision surgeries could save millions for NHS Scotland.
• Scalability. The PKA system’s design allows potential applications in other surgical fields.

The PAS Conference, established in 2020, has become a global hub for advancing personalised arthroplasty, attracting experts and leading companies like DePuy Synthes and Stryker. Held at Roma Eventi Fontana di Trevi, the 2025 event will showcase innovations in surgical techniques and implant design. This research aligns with NHS Golden Jubilee’s commitment to innovation, evidenced by their recent University Status from the University of Glasgow and collaborations like the ROBUST Egypt for knee replacement recovery through radar-based monitoring and blood flow restriction training.