Dr Tarandeep Singh Gill — MS Ortho, MCh Ortho
Director – Joint Replacement & Robotic Surgery · RoboLens FT3D Pioneer · Max Super Speciality Hospital, Mohali
The distinction between knee resurfacing and full knee replacement is one of the most common things patients get wrong when they research their options. The two procedures are often described as a spectrum — “start with resurfacing, do full replacement later” — but that’s not quite right. They’re different tools for different clinical situations. FT3D changes the decision point for resurfacing significantly.
The Basic Difference
Full knee replacement removes the entire articulating surface — the cartilage and bone surface at the bottom of the femur, the top of the tibia, and the undersurface of the patella — and replaces all of it with metal and polyethylene components. The cruciate ligaments are sacrificed in standard total knee replacement; posterior-stabilised designs compensate for this.
Knee resurfacing replaces only the damaged areas. If arthritis has worn out one compartment but left the other surfaces intact, resurfacing treats that compartment and leaves everything else. Bone stock is preserved. Cruciate ligaments remain. The joint retains more of its native structure and, for most patients, feels more natural as a result.
Why FT3D Changes the Resurfacing Decision
Conventional resurfacing — done by hand or with conventional cutting guides — has a precision problem. The components are smaller than in total replacement and fit to a specific surface geometry. An error in positioning of 2–3 degrees that would be tolerable in a full replacement becomes clinically significant in a resurfacing. This is why some surgeons were historically cautious about offering resurfacing: the margin for error is tight, and surgical precision was the limiting factor.
FT3D closes that margin with real-time robotic guidance. The live intraoperative imaging means the system maps exactly where the cuts need to go, confirms it before any bone is removed, and guides execution to sub-millimetre accuracy. The precision that was previously the limitation of resurfacing is now one of its strengths when done with FT3D.
This changes the recommendation calculus. Patients who might previously have been told “resurfacing is too risky, let’s do total replacement” are now candidates for resurfacing with FT3D — because the precision gap has been addressed.
Who Gets Which Procedure
FT3D resurfacing: isolated single or two-compartment disease, intact cruciate ligaments on MRI, moderate deformity that’s correctable, adequate bone stock. Age is less of a strict criterion than it used to be — younger patients with isolated compartmental damage are the strongest candidates, but well-selected older patients also do well.
Full knee replacement: all three compartments damaged (pan-compartmental arthritis), inflammatory arthritis affecting multiple compartments, severe fixed deformity, compromised cruciate ligaments, or cases where the bone stock is insufficient for resurfacing. Also appropriate when the arthritic damage is too extensive for a targeted resurfacing approach.
The decision is made from imaging — a standing weight-bearing X-ray and MRI of the knee — combined with clinical examination. Dr Gill will look at the imaging and tell you clearly which category your knee falls into and what the right procedure is. Book at tsgillortho.com/appointment or call +91-82880 15106.
