Meril Cuvis Joint Robotic Surgery System

Precision-Guided Robotic Technology for Total Knee Replacement

Overview

The Meril Cuvis Joint Robotic Surgery System is an advanced robotic-assisted surgical platform designed specifically for total knee arthroplasty (TKA), commonly known as total knee replacement surgery. Based on the Curexo CUVIS-joint platform developed in South Korea, the system is manufactured and marketed in India by Meril Life Sciences Pvt. Ltd.

Unlike multi-specialty robotic surgical platforms, the Cuvis Joint is purpose-built for orthopaedic knee surgery. It combines CT-based 3D pre-operative planning with a precision robotic arm and optical tracking technology to assist the orthopaedic surgeon in achieving accurate bone preparation and optimal implant positioning during knee replacement procedures.

At Apollo Hospitals, the Cuvis Joint system is part of our comprehensive robotic-assisted joint replacement programme, reflecting our commitment to providing patients with the most advanced surgical technologies for improved outcomes and faster recovery.

Purpose

The primary purpose of the Meril Cuvis Joint system is to enhance the precision and accuracy of total knee replacement surgery. The system is designed to assist the orthopaedic surgeon with:

• Personalised surgical planning: Creating a patient-specific 3D surgical plan based on CT imaging of the knee.
• Precise bone preparation: Using a robotic arm with a milling tool to prepare the bone surfaces with sub-millimetre accuracy, tailored to each patient’s unique anatomy.
• Accurate implant alignment: Helping ensure that the knee implant is positioned and aligned correctly, which is a key factor in the long-term success of the replacement.
• Real-time surgical guidance: Providing the surgeon with continuous feedback through optical tracking during the procedure.

The Cuvis Joint system is indicated for total knee arthroplasty only. It is not designed for partial knee replacement, hip replacement, spine surgery, or any soft-tissue, urological, gynaecological, or cardiac procedures.

How the Cuvis Joint System Works

The Meril Cuvis Joint system uses optical tracking technology and a robotic arm equipped with a precision bone-milling tool to assist the orthopaedic surgeon throughout the knee replacement procedure. It does not use an endoscopic camera. The surgical workflow involves the following key steps:

Step 1: Pre-Operative Planning

Before surgery, a CT scan of the patient’s knee and lower limb is performed. The Cuvis Joint software processes this scan to create a detailed 3D model of the patient’s bone anatomy.

Using this model, the surgeon plans the surgery virtually — determining the optimal position, alignment, and size of the knee implant components based on the patient’s individual anatomy.

Key measurements such as the hip-knee-ankle (HKA) axis, medial proximal tibial angle (MPTA), and lateral distal femoral angle (LDFA) are calculated to guide the surgical plan.

Step 2: Intra-Operative Registration

During surgery, the surgeon registers specific anatomical landmarks on the patient’s knee. The system’s optical tracking cameras identify these landmarks and match them to the pre-operative 3D plan.

This registration step ensures that the robotic system accurately understands the patient’s real-time anatomy in relation to the surgical plan.

Step 3: Robotic-Assisted Bone Preparation

Once registration is complete, the robotic arm assists the surgeon in preparing the bone surfaces.

Instead of using conventional manual cutting guides and saws, the Cuvis Joint system uses a high-speed milling tool mounted on the robotic arm to remove bone with precision.

The system follows the pre-operative plan while the surgeon maintains direct oversight and control throughout the procedure.

The optical tracking system provides real-time feedback to ensure that bone removal stays within the planned parameters.

Step 4: Implant Placement

After the bone surfaces have been prepared, the surgeon places the knee implant components — typically including a femoral component, tibial baseplate, and polyethylene insert.

The precision of the robotic-assisted bone preparation is designed to help achieve optimal fit and alignment of the implant, which contributes to joint stability and function after surgery.

Benefits of the Cuvis Joint Robotic System

The Cuvis Joint system offers several advantages that may benefit patients undergoing total knee replacement:

• CT-based personalised planning: The 3D surgical plan is customised to each patient’s unique bone anatomy, enabling a tailored approach rather than relying on standard sizing guides.
• Sub-millimetre cutting accuracy: The robotic milling tool is designed to prepare bone surfaces with a high degree of precision, potentially reducing the variability seen with conventional manual techniques.
• Real-time optical tracking: The system continuously monitors the surgical field during the procedure, providing the surgeon with live feedback and guidance.
• Improved implant alignment: Accurate bone preparation is designed to support proper implant positioning, which is associated with better long-term function and durability of the knee replacement.
• Designed for the Indian healthcare setting: Manufactured by Meril Life Sciences and cleared by CDSCO, the system is designed for accessibility in Indian hospitals and has a growing base of clinical experience across Indian orthopaedic centres.

Who Can Benefit from the Cuvis Joint System?

Patients who may be suitable candidates for robotic-assisted total knee replacement with the Cuvis Joint system include those with:

• Advanced osteoarthritis of the knee with significant pain and functional limitation
• Knee joint deformities, including varus or valgus malalignment, where precise correction is important
• Rheumatoid arthritis or post-traumatic arthritis requiring total knee replacement
• Failed conservative treatment (medications, physiotherapy, injections) where surgery is the recommended next step

Not all patients require robotic-assisted surgery, and the decision is made jointly by the patient and their orthopaedic surgeon based on the individual clinical situation.

Limitations and Considerations

As with any surgical technology, it is important for patients to understand the limitations of the Cuvis Joint system:

• Requires a pre-operative CT scan: Unlike some robotic systems that are image-free, the Cuvis Joint relies on CT imaging for planning, which involves a small amount of radiation exposure.
• Initial setup time: The registration and calibration steps may add to the overall surgical time, particularly during the initial phase of adoption. Surgical time typically improves as the surgeon and team gain experience with the system.
• Total knee replacement only: The system is not indicated for partial knee replacement, revision knee surgery, hip replacement, or other orthopaedic procedures.
• Outcomes depend on multiple factors: While robotic assistance is designed to improve precision, surgical outcomes are also influenced by surgeon experience, patient health, and post-operative rehabilitation.

Recovery After Robotic-Assisted Knee Replacement

Recovery following robotic-assisted total knee replacement with the Cuvis Joint system is generally similar to conventional total knee replacement.

Patients can typically expect:

• Mobilisation with assistance within 24 hours of surgery
• A structured physiotherapy programme beginning in the hospital and continuing after discharge
• Hospital stay of approximately 2–4 days, depending on the patient’s progress
• Return to light daily activities within a few weeks, with full recovery over 3–6 months

The precision of robotic-assisted bone preparation may contribute to a well-fitting implant, which can support a smoother recovery process. However, individual recovery timelines vary based on age, overall health, and adherence to the rehabilitation programme.

Frequently Asked Questions

1. Is the Cuvis Joint system the same as the da Vinci robotic system?

No. The da Vinci system is a multi-specialty robotic platform used for soft-tissue surgeries such as urological, gynaecological, and general surgical procedures.

The Cuvis Joint is an entirely different system, designed exclusively for robotic-assisted total knee replacement. The two systems use different technologies and are used for different types of surgery.

2. Does the robot perform the surgery on its own?

No. The Cuvis Joint is a surgeon-controlled system.

Your orthopaedic surgeon operates the system, makes all clinical decisions, and maintains direct control throughout the procedure.

The robotic arm assists with precision bone preparation based on the pre-operative plan, but the surgeon guides and oversees every step.

3. Does the system use a camera inside the knee?

No. The Cuvis Joint system uses external optical tracking cameras to monitor the surgical field. It does not use an endoscopic or arthroscopic camera.

This is different from soft-tissue robotic systems that rely on internal camera visualisation.

4. Is a CT scan necessary before surgery?

Yes. The Cuvis Joint system requires a pre-operative CT scan of the knee and lower limb.

This scan is used to generate the 3D model for surgical planning. The radiation dose from a limb CT scan is relatively low.

5. Can the Cuvis Joint system be used for partial knee replacement or hip replacement?

No. The Cuvis Joint system is currently indicated for total knee arthroplasty only.

It is not designed for partial (unicompartmental) knee replacement, hip replacement, revision surgery, or any other orthopaedic or surgical procedure.

6. Is robotic-assisted knee replacement better than conventional knee replacement?

Robotic assistance is designed to improve the precision of bone preparation and implant alignment compared with conventional instrumentation.

Early clinical evidence suggests favourable outcomes; however, long-term data is still being gathered.

Your orthopaedic surgeon can advise you on whether robotic-assisted surgery is appropriate for your specific condition.

7. Is the Cuvis Joint system approved for use in India?

Yes. The Cuvis Joint system is manufactured by Meril Life Sciences and has been cleared by the Central Drugs Standard Control Organisation (CDSCO) for use in India.

8. How do I find a surgeon who uses the Cuvis Joint system?

Consult your orthopaedic specialist or contact Apollo Hospitals to find a surgeon trained in robotic-assisted knee replacement using the Cuvis Joint system.

Regulatory Status

The Meril Cuvis Joint Robotic Surgery System is cleared by the Central Drugs Standard Control Organisation (CDSCO) for use in India.

It is manufactured by Meril Life Sciences Pvt. Ltd. and is based on the Curexo CUVIS-joint platform.

Patients should discuss with their orthopaedic surgeon whether robotic-assisted total knee replacement is appropriate for their specific condition and clinical needs.

Book an Appointment

If you or a loved one is considering total knee replacement surgery, the Meril Cuvis Joint Robotic Surgery System may be the right choice for you.

Experience the benefits of advanced robotic-assisted surgical technology and personalised care at Apollo Hospitals.

To book an appointment with an orthopaedic specialist, visit apollohospitals.com/book-doctor-appointment or contact your nearest Apollo Hospitals centre.