Frequently Asked Questions

You may be a candidate for joint replacement if you experience persistent pain that limits daily activities — such as walking, climbing stairs, or sleeping — and conservative treatments (physical therapy, injections, medications, bracing) have not provided adequate relief. X-rays showing bone-on-bone arthritis, along with pain that affects your quality of life, are the most common reasons patients proceed with surgery. Dr. Lupo will evaluate your imaging, physical exam, and functional limitations during your consultation to determine if surgery is appropriate.

Robotic-arm assisted surgery uses a CT scan to create a 3D model before surgery. Dr. Lupo plans implant position on this model, and the system provides real-time guidance and haptic boundaries during the procedure. Dr. Lupo controls every movement; the robot does not operate independently.

No. Dr. Lupo performs the surgery. The robotic system provides feedback and physical boundaries that help him work within the surgical plan. The robot does not move independently or make clinical decisions.

Most joint replacement surgeries are performed under spinal anesthesia (a numbing injection in the lower back) combined with sedation so you are comfortable and relaxed. This avoids the risks of general anesthesia and often results in less nausea and a faster recovery. The anesthesiologist will discuss options with you before surgery and recommend the safest approach based on your health history.

A typical robotic knee or hip replacement takes approximately 60 to 90 minutes of surgical time. You will be in the operating room for approximately 2 hours total, which includes preparation, anesthesia, and post-operative monitoring. Robotic planning is done before surgery using your CT scan, so it does not add significant time to the procedure.

Among appropriately selected patients, the practice reports a 95% same-day discharge rate. Discharge depends on medical readiness, mobility, and support at home, and the hospital team will confirm when it is safe.

Therapy needs differ by procedure and patient. Your plan may include supervised mobility in the hospital, home exercises, home-based therapy, outpatient therapy, or a combination. The care team will provide instructions based on your strength, balance, support, and progress.

Implant longevity varies with implant design, activity, health, body weight, positioning, and other factors. Modern materials and accurate placement are intended to support durability, but no technique can guarantee how long an implant will last.

All surgery has risks, including infection, blood clots, nerve or blood-vessel injury, stiffness, instability, implant wear or loosening, and the possible need for additional treatment. This is not a complete list. Dr. Lupo will review benefits, alternatives, and risks that apply to your health and planned procedure.

There is no strict age limit for joint replacement. The decision is based on your pain level, functional limitations, and overall health — not your age alone. Patients in their 50s through their 90s have successful outcomes. For younger patients, the primary consideration is implant longevity, which is why precise robotic placement is especially valuable — better alignment means less wear and a longer-lasting implant.

Being overweight increases stress on your joints and can affect surgical outcomes. However, many patients with elevated BMI still benefit significantly from joint replacement. In some cases, Dr. Lupo may recommend weight loss before surgery to reduce risks and improve outcomes. Each patient is evaluated individually — weight alone does not disqualify you from surgery.

Modern implants may or may not trigger airport security scanners. You should inform security before you go through a scanner that you have a joint replacement. Wear loose, comfortable clothing that can be easily patted down, or be prepared to show them a surgical scar. We do not use joint replacement cards, as they do not work. This is a minor inconvenience that most patients find easily manageable.

Recommendations may depend on your health, dental procedure, time since surgery, and guidance from your surgeon and dentist. Tell your dentist that you have a joint replacement and ask Dr. Lupo's office if you are unsure. Do not start or stop antibiotics based only on general website information.

Your surgical and prescribing teams must provide medication-specific instructions. Do not stop blood thinners, aspirin, anti-inflammatory medicines, diabetes medicines, supplements, or any prescription drug on your own. Your preoperative review will identify what to continue, pause, or adjust and when.

Remove throw rugs and tripping hazards. Place frequently used items at counter height. Consider a raised toilet seat and shower chair if recommended. Stock your kitchen with easy-to-prepare meals and arrange for help during the early recovery period. If your bedroom is upstairs, ask the care team whether a temporary main-floor sleeping area would be helpful for your individual plan.

MAKO robotic-assisted hip and knee replacement is available locally through Dr. Lupo at AHN Saint Vincent Hospital in Erie. Staying local may reduce travel and make family support and follow-up coordination easier. Patients should compare surgeon experience, the planned approach, hospital support, and how each option fits their needs.

Dr. Lupo does not charge a separate concierge membership fee for access to the practice. Normal insurance deductibles, copays, coinsurance, facility charges, and other medical costs may still apply. Call the office and your insurer for plan-specific information.

The subvastus approach accesses the knee from beneath the vastus medialis, preserves the quadriceps tendon, and does not cut the quadriceps muscle. Published studies report differences in some early-recovery measures compared with standard approaches, but individual pain, strength, and mobility vary.

A commonly used medial parapatellar approach opens the joint through the quadriceps tendon. Dr. Lupo's modified subvastus approach reaches the joint beneath the vastus medialis with the goal of preserving the extensor mechanism. Published studies report differences in some early-recovery measures, but pain, mobility, and discharge timing vary by patient.

Some patients can perform a straight leg raise early after a subvastus knee replacement, but timing varies with strength, swelling, pain control, anesthesia, and other factors. The care team will assess quadriceps function and mobility after surgery.

The robotic system uses a CT scan to create a 3D model of your knee. Dr. Lupo plans implant size, position, and alignment on that model. During surgery, feedback and haptic boundaries help him work within the plan and assess alignment and ligament balance. The technology assists the surgeon; it does not guarantee a particular feel or implant lifespan.

When arthritis affects only one compartment of the knee (typically the inner/medial side), a partial knee replacement resurfaces only the damaged area while preserving healthy bone, cartilage, and all ligaments (including the ACL). This is a less invasive procedure with faster recovery, more natural knee feel, and better range of motion compared to a total knee replacement. Robotic guidance ensures the partial implant is positioned with the same precision as a total replacement. Not all patients are candidates — Dr. Lupo will determine if your arthritis pattern is appropriate for a partial replacement.

Mobility commonly begins soon after surgery when medically appropriate. Weight-bearing, stairs, walking aids, and the pace of progression depend on your procedure, strength, balance, and the care team's assessment.

Driving should resume only after Dr. Lupo clears you, you are no longer taking impairing medication, and you can enter the vehicle and operate the pedals safely. Timing varies by the operated side, strength, reaction time, and recovery.

Return to golf, swimming, cycling, tennis, and other activities depends on healing, strength, balance, implant considerations, and prior experience. Dr. Lupo will provide activity-specific guidance and clearance based on your progress.

Most patients report significant pain relief and greatly improved function. However, a replaced knee will feel different from a natural knee — most patients describe a slight awareness that something is different, particularly with deep bending. That said, robotic-arm assisted placement and the muscle-sparing approach produce a more natural-feeling result than traditional techniques because the implant is positioned to work with your specific anatomy and your quadriceps muscle is preserved.

Some patients notice occasional clicking or a sensation of movement in their replaced knee. This is normal and typically caused by the implant components moving against each other during certain activities. It is not painful and does not indicate a problem. Precise robotic placement can minimize these sensations by optimizing implant alignment.

The subvastus approach works well for the majority of knee replacement patients. However, it may be more challenging in patients with severe obesity, very muscular thighs, significant valgus (knock-knee) deformity, or very stiff knees with limited range of motion. Dr. Lupo will evaluate your specific anatomy during your consultation and recommend the approach that will give you the best outcome.

A trademarked program name does not by itself explain the surgical approach or predict an outcome. Ask how the surgeon reaches the joint, how implant position is planned, what evidence applies, and how much experience the surgeon has. Dr. Lupo uses an enhanced medial oblique modified subvastus approach adapted for robotic-assisted planning.

The direct anterior approach accesses the hip from the front and goes between natural muscle planes. With Dr. Lupo's approach, no muscles are cut, split, or detached from bone. Recovery still varies by patient.

Anterior and posterior approaches use different access routes, and each has potential advantages, risks, and surgeon-specific protocols. The direct anterior approach works between natural muscle planes and commonly avoids routine tendon detachment. Ask which approach fits your anatomy and what precautions and recovery plan would apply to you.

There are no routine hip precautions for most direct anterior patients. You may bend, cross your legs, and tie your shoes unless Dr. Lupo gives you different instructions based on your individual surgery.

The robotic system provides real-time data on three critical measurements during hip replacement: 1. Cup positioning — The socket must be positioned in a way that creates stability. Robotic guidance ensures this is achieved precisely. 2. Leg length — Unequal leg length after hip replacement is a common patient complaint. The robotic system measures leg length in real-time, allowing Dr. Lupo to work toward restoring your natural length as closely as possible. 3. Offset — This determines proper muscle tension around the hip. Correct offset means the hip feels stable and the muscles work efficiently. Dr. Lupo uses an enhanced robotic workflow that provides more data and information for accurately positioned implant plans, as opposed to the express workflow used by the vast majority of robotic surgeons. These three factors determine how natural your hip feels, how stable it is, and how long the implant lasts.

Leg length discrepancy is one of the most common complaints after traditional hip replacement. Dr. Lupo uses an enhanced robotic technique and does everything possible to make your leg lengths as close to even as possible. However, in severely shortened hips, there may be a limit to how far the leg can be lengthened. Additionally, if the hip is very loose, he may need to lengthen the leg slightly to create stability. Either way, Dr. Lupo does his best to achieve an unrecognizable leg length difference — a significant advantage over non-robotic techniques where leg length is estimated rather than measured.

It is common to have a small area of numbness on the outer front of the thigh after anterior approach hip replacement. This is caused by a small sensory nerve (the lateral femoral cutaneous nerve) that runs near the surgical approach. In most patients, the numbness resolves within a few weeks to months. If it persists, it is typically a small patch that patients describe as not bothersome. This is a cosmetic sensory issue only — it does not affect muscle function or strength.

Mobility commonly begins soon after surgery when medically appropriate. Weight-bearing, stairs, walking aids, driving, and return to activities depend on your procedure, health, balance, medications, home support, and Dr. Lupo's clearance.

Driving should resume only after Dr. Lupo clears you, you are no longer taking impairing medication, and you can safely enter the vehicle, sit comfortably, and operate the pedals with normal reaction time. Timing varies.

Many patients return to low-impact activities after rehabilitation, but activity recommendations depend on healing, balance, implant considerations, and prior experience. Dr. Lupo will provide guidance for the activities that matter to you.

Dislocation risk varies by anatomy, diagnosis, approach, component position, activity, and other factors. Published studies report differences between approaches and guidance methods, but no approach eliminates risk. Dr. Lupo will explain the considerations that apply to you.

The direct anterior approach may not be the best option for every patient or every operation. Anatomy, prior surgery, body composition, deformity, and whether the procedure is a revision can affect the recommended approach. Dr. Lupo will explain which option fits your situation.

Some surgeons use specialized tables (like the HANA table) for anterior hip replacement, but they are not required. Dr. Lupo performs the anterior approach on a standard operating table, which provides flexibility and is combined with robotic guidance for precise implant positioning. The key factor is the surgeon's training and experience with the approach, not the table used.

During your first visit, Dr. Lupo will review your X-rays (or order new ones), perform a physical examination of your joint, discuss your symptoms and how they affect your daily life, and review your medical history. If surgery is appropriate, he will explain the procedure, expected outcomes, and answer all your questions. You will leave with a clear understanding of whether joint replacement is right for you and what the next steps are.

Pre-operative requirements may include: • CT scan of the affected joint for robotic planning • Blood work • EKG • Medical clearance • Additional testing based on age, health history, and hospital requirements The office and hospital team will tell you which tests apply and when each must be completed.

Pre-operative activity may help some patients prepare for surgery, but the right plan depends on pain, balance, strength, heart health, and other conditions. Ask Dr. Lupo's team whether walking, cycling, range-of-motion work, or strengthening is appropriate for you, and follow the individualized program they provide.

If your BMI is significantly elevated, losing weight before surgery can reduce surgical risks, improve outcomes, and speed recovery. However, many patients with joint pain find it difficult to exercise enough to lose weight — which is part of why they need the surgery. Dr. Lupo evaluates each patient individually and will discuss whether weight loss is recommended or required before proceeding.

Blood thinners must be managed by your surgical and prescribing teams. Do not stop warfarin, apixaban, rivaroxaban, aspirin, or any other prescribed medication on your own. The exact plan and timing depend on the medicine, procedure, kidney function, clotting risk, and whether another treatment is needed temporarily. Follow the written instructions provided for you.

Follow the exact fasting and medication instructions provided by the hospital and surgical team. The permitted timing for food, clear liquids, and morning medicines can vary by procedure, arrival time, health conditions, and anesthesia plan. If your written instructions are unclear, call before surgery rather than relying on general website guidance.

Mobility begins when the hospital team determines it is safe. Among appropriately selected patients, the practice reports a 95% same-day discharge rate. Your plan may include supervised walking, stairs when needed for home access, a walking aid, and individualized therapy.

Your discharge instructions will provide a patient-specific pain plan that may include ice, elevation, prescribed medicines, and appropriate movement. Take medicines only as directed, and call the office if pain is not controlled or you have medication concerns.

Therapy and home-exercise timing depend on the procedure, strength, balance, mobility, and discharge plan. Follow the written plan from Dr. Lupo, the hospital team, and your therapist rather than a general website schedule.

Follow your discharge instructions for the dressing, showering, and incision care because the plan depends on the closure and dressing used. Keep the area protected as directed, do not scrub or submerge the incision until the team clears you, and do not apply products unless instructed. Contact Dr. Lupo's office promptly for increasing redness, warmth, swelling, drainage, fever, or another concern identified in your discharge instructions.

Showering depends on the dressing, incision closure, balance, and instructions provided at discharge. Do not remove a dressing, shower, or submerge the incision based only on a general timeline. Follow your written plan, use recommended safety equipment, and call the office if you are unsure.

Your blood-clot prevention plan is individualized and may include prescribed medication, movement, exercises, compression, and hydration guidance. Use the medicine, dose, and duration in your discharge instructions rather than a general website schedule. Seek urgent medical care for chest pain, shortness of breath, fainting, or other emergency symptoms; call the office promptly for new calf pain or swelling.

Return to work depends on the procedure, healing, strength, medications, commute, and the physical demands of your job. Dr. Lupo will provide clearance based on your recovery and work requirements.

Living alone does not automatically prevent joint replacement, but the discharge plan must be safe. Arrange the level and duration of help recommended by the care team, prepare meals, place essentials within reach, and discuss stairs and sleeping arrangements before surgery. If home support is insufficient, the hospital team will discuss the appropriate discharge options based on your needs.

Recovery milestones vary. Mobility commonly begins soon after surgery when medically appropriate, but weight-bearing, walking aids, driving, work, and return to activities depend on your procedure, health, balance, medications, home support, rehabilitation, and Dr. Lupo's clearance.

Referral, authorization, network participation, and out-of-pocket costs depend on your insurance plan. Call Dr. Lupo's office at (814) 454-2401 and your insurer to verify requirements before your visit.

Referral, authorization, network participation, and out-of-pocket costs depend on your insurance plan. Call Dr. Lupo's office at (814) 454-2401 and your insurer to verify requirements before your visit.

Dr. Lupo performs the robotic hip and knee replacement procedures described on this website at AHN Saint Vincent Hospital's Total Joint Center in Erie, Pennsylvania. Consultations take place at the AHN Orthopaedic Institute. The care team will provide the correct hospital arrival instructions before surgery.

AHN describes its Saint Vincent joint replacement program as including nurse navigation, preoperative education, and rehabilitation support. The services used by each patient depend on the procedure and individual care plan.

Appointments are scheduled by telephone. Call (814) 454-2401 Monday through Friday from 8:30 AM to 5:00 PM and ask to schedule with Dr. Robert Lupo. The website and chat assistant do not submit or reserve appointments.

Timing varies according to medical readiness, required testing, authorization, CT-based planning, and hospital availability. After you and Dr. Lupo decide to proceed, the care team will explain the preparation steps and available dates.