By Shauna Mazenes
Harold Harris has always led an active life.
From directing films to playing tennis and even making music, his passion for movement was undeniable.
However, arthritis in his knee gradually eroded his ability to enjoy these activities, leaving him struggling with everyday tasks.
"When you lose your mobility, it's unexpected — no matter what age you're at," says Harold, 71.
That changed in late April when he became one of the first patients in Canada to undergo a robotic-assisted partial knee replacement at UHN. This cutting-edge procedure, performed in UHN's Sprott Department of Surgery at Toronto Western Hospital, promises faster recovery and more consistent outcomes, thanks to the precision of robotic technology.
"For those patients who are candidates, partial knee replacements have well-described benefits as a less invasive surgery with fewer complications and higher satisfaction rates," says Dr. Michael Zywiel, the orthopedic surgeon who led the team performing Harold's surgery. "But there has been limitations in its adoption because it's a more technically demanding procedure.
"By applying the latest generation of robotics to partial knee surgery, we're able to very accurately size and position the implants to get just the right ligament tension and achieve all those benefits."
Harold's journey with knee arthritis began just over two decades ago when he tore his ACL playing tennis. While it was initially reconstructed, he tore it again shortly after, forcing him to give up running and tennis.
"For the past 21 years, there's been a rise and fall in my ability to do things with my legs," says Harold.
Not only was he unable to do what he loved, but simple tasks such as helping out around the house, going up the stairs, or carrying his guitar became a daily challenge.
Dr. Zywiel says it's a common story.
"Knee arthritis or general wear and tear of the knee is not something that can be reversed," he says. "It's all about managing symptoms.
"But it gets to a point where patients are miserable on a regular basis and it can really impact quality of life."
That, he says, is when doctors suggest the option of a knee replacement.
Total knee replacements generally substitute all three compartments of the knee with plastic and metal. Partial knee replacements only deal with one of those affected areas.
A partial knee replacement may be a better option for some patients, as it's less invasive with an easier recovery and better results. However, partial knee replacements are more difficult to perform and associated with greater risks if done incorrectly.
Dr. Zywiel says potentially up to 45 per cent of patients presenting to knee and hip clinics are considered good candidates for a partial knee replacement. Yet, only five per cent of knee replacement surgeries in Canada are partial. One reason may be because of how finicky and technically-challenging the procedure is.
But the VELYS system is changing that. By leveraging such robotics, UHN aims to increase the adoption of this technique across the country, giving more patients access to the benefits of a partial knee replacement.
Scheduled to open in 2028, the new Surgical Tower at Toronto Western Hospital will feature advanced operating rooms designed for complex orthopedic surgeries such as these. The infrastructure will allow for the integration of artificial intelligence, augmented reality and minimally invasive robotic procedures — positioning UHN at the forefront of medical innovation.
UHN performed Canada's first robot-assisted total knee replacement with the VELYS system in 2023, a surgery led by Dr. Zywiel.
While the thought of a robot-assisted knee replacement was a daunting one, Harold wasn't afraid to take the risk.
"Over the last couple of years, it's certainly gotten worse to the point where I made the decision to have elective surgery to cut a piece of my knee away and get a piece of metal stuck in there," he says.
"That's a pretty big decision. But clearly, it was the right thing to do."
Harold says his experience post-surgery has been nothing short of transformative. He was stunned by how much better he felt almost immediately after waking up.
"It's fantastic," Harold says. "The fact that I was able to walk out of the hospital comfortably and function quite well is better than I hoped."
One week in, his mobility has already significantly improved. Harold is able to walk greater distances, exercise better, and negotiate heavier tasks with minimal pain.
"I've had skateboarding injuries that hurt worse," he jokes, referencing his teenage years.
As he does rehab with a specialist at UHN, Harold looks forward to swimming again and feels good about his recovery.
Now, he wants other Canadians to know that having access to a procedure like this is a gift.
"The fact that no matter where you're at in terms of your money, your status – if you're Canadian – you have as much opportunity as the next person to have a better quality of life," he says.
"And that's pretty incredible."
