Internet Explorer no longer supports some features of our website. For best results, use Microsoft Edge, Google Chrome, Firefox, or Safari.
Navio Robotic-Assisted Knee Surgery

Navio Robotic-Assisted Knee Surgery

AppOrtho is the first and only orthopedics practice in western NC to offer robotics-assisted partial and total knee replacement using the NAVIO® surgical system, only at Watauga Medical Center.

How do I know if I am a candidate for robotics-assisted partial or total knee replacement using the NAVIO® system?

Although each patient must consult with a physician individually, typical partial knee replacement candidates share the following characteristics:

  • Knee pain that limits your activities regularly
  • Knee pain due to osteoarthritis
  • Non-surgical treatments are no longer effective

Meet with a NAVIO® trained orthopedic surgeon at AppOrtho today to see if robotics-assisted surgery is right for you. 

Partial Knee Replacement

Total Knee Replacement

NAVIO®-Trained Surgeons

Patient Testimonials

Individual results may vary. There are risks associated with any surgical procedure including NAVIO-enabled Knee Replacement. NAVIO is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, morbidly obese patients, or any other patients contraindicated for UKR, PFA, or TKA should not undergo a NAVIO procedure. Consult your physician for details to determine if NAVIO is right for you.

NAVIO® Robotics-Assisted Surgery System

NAVIO Robotics-assisted Surgical System

Meet the NAVIO Surgical System, a robotics-assisted knee surgery platform that adds an extra layer of pre-surgical planning and improved precision for partial and total knee replacement procedures.

NAVIO Robotics-assisted knee replacement surgery

Your knee replacement surgery is unique, based on your knee anatomy and the implant used. Designed to help ensure your knee replacement is positioned and aligned correctly, surgeons use the NAVIO Surgical System. Proper positioning of the implant is important because implant alignment is a crucial factor in determining how long your implant may last.1, 2

Decades of innovation in knee replacement surgery

Surgical techniques have evolved considerably since the earliest knee implant procedures were performed in 1968. These procedures relied on manual guides, external pins and cutting jigs to remove damaged bone and place the prosthetic implant.

Eventually more advanced implant positioning techniques were introduced that used long rods drilled into the central canal of the femur (thigh bone). These rods provide an attachment point for surgical cutting guides. More recent improvements introduced CT (computerized tomography) scan/MRI image guidance to create an individualized computer-generated surgical plan for each patient.

The latest innovation is the NAVIO Surgical System, a robotics-assisted platform that uses CT-free technology for precise implant sizing and positioning without the need for rods. The NAVIO Surgical System can be used for either a partial or total knee replacement procedure.

NAVIO system benefits: accuracy, less exposure to CT radiation

The NAVIO system offers two important benefits for people undergoing a knee replacement procedure. First, it helps your surgeon create a highly individualized plan that is specific to the unique shape and motion of your knee. Traditional planning may require CT scans, a series of images similar to x-rays that shows cross-sections of your knee. While other robotic-assisted platforms require CT scans, the NAVIO system works without them, meaning you are not exposed to the potentially harmful radiation experienced with this type of imaging.

The second benefit is robotic assistance. This combination of advanced technology is designed to help your surgeon and may result in more accuracy, giving you better long-term outcomes.

The NAVIO system is used for both partial and total knee replacement, which are distinctly different procedures. Here's a bit more information on how the NAVIO system is used in these surgeries:

Partial knee replacement

In partial knee replacement, your supporting tissue and ligaments that help stabilize your knee are spared and only the damaged portion of the knee is replaced. This means that healthy cartilage and bone remain intact to help your knee joint move smoothly with the prosthetic implant. Patients with osteoarthritis in only one area of their knee may be candidates for partial knee replacement.

Patients who undergo partial knee replacement often report a 'more normal' feeling knee, less pain and quicker rehabilitation3.

Robotics-assisted planning and partial knee surgical procedure

Using the NAVIO system, your surgeon creates a 3D representation of the unique shapes and profiles of your knee without the need of a pre-operative CT scan.

Using all of this information your surgeon can then determine the correct size and position of the implant. Implant size and position is critical to knee alignment and stability.

Next, your surgeon uses robotic assistance of NAVIO to physically remove only the damaged bone, preparing the site for the prosthesis, before placing and adjusting your partial knee implant.

Total knee replacement

In total knee replacement, the entire knee joint is replaced with a prosthetic implant designed to replicate the shape, motion and stability of your natural knee joint. Total knee replacement is one of the most common procedures performed in all of medicine, with over 600,000 performed in the U.S. every year. Ninety percent of people who receive a total knee replacement experience a dramatic decrease in knee pain, and an improvement in their ability to perform daily activities.4

Robotics-assisted planning, and total knee surgery guidance

Just as in the partial knee procedure described above, your surgeon creates a 3D representation of the unique anatomy of your knee without the need of a pre-operative CT scan.

Your surgeon uses your knee anatomy information to determine the correct size and position of the implant, and creates a surgery plan unique to your anatomy.

Important safety notes

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.


Individual results may vary. There are risks associated with any surgical procedure including NAVIO-enabled Knee Replacement. NAVIO is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, and morbidly obese patients and patients contraindicated for UKR, PFA and TKA should not undergo a NAVIO procedure. Consult your physician for details to determine if NAVIO is right for you.


  1. Collier, Matthew, et al., "Patient, Implant, and Alignment Factors Associated With Revision of Medial Compartment Unicondylar Arthroplasty.", Jour of Arthro, Vol 21 No 6, Suppl. 2, 2006.
  2. Hernigou, Ph, Deschamps, G., "Alignment Influences Wear in the Knee after Medial Unicompartmental Arthroplasty.", Clin Orthop Relat Res., Volume 423, June 2004, pp 161-165
  3. Hall et al., "Unicompartmental Knee Arthroplasty (Alias Uni-Knee): An Overview with Nursing Implications," Orthopaedic Nursing, 2004; 23(3): 163-171.
  4. American Academy of Orthopaedic Surgeons website, accessed March 7, 2017: //

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.

Why does my shoulder hurt? An orthopedic surgeon weighs in

Why does my shoulder hurt? An orthopedic surgeon weighs in

Benjamin Parker, MD

Benjamin Parker, MD

Dr. Benjamin Parker is an orthopedic surgeon at AppOrtho and orthopedic medical director for App State Athletics. AppOrtho is the official sports medicine provider for App State Athletics, Watauga High School, and the High Country Soccer Association. Learn more about Dr. Parker >

Request an Appointment

Many people experience shoulder discomfort or pain at some point in their lives. Why does your shoulder hurt? The shoulder is a complex joint, made up of multiple muscles, tendons, and bones that work together to allow us to perform everyday activities – from playing basketball, to working in the garden.  When just one of these components is disrupted by overuse or injury, the shoulder can become painful. Pain in the shoulder can present itself in many different ways, which can be overwhelming and confusing. Do you need shoulder surgery? Maybe, but there are some non-surgical options to consider first. This article’s purpose is to provide information and possible treatment options for common causes of shoulder pain. If you are suffering from shoulder pain, please contact AppOrtho online or call (828) 386-2663.


As we age, our bodies go through some wear and tear, which can result in an arthritic shoulder. This is a normal process that middle-aged to elderly individuals begin to experience.

Symptoms: Shooting and catching pain that originates in the shoulder and stops at the elbow is a common sign of an arthritic shoulder. Overuse of an arthritic shoulder can cause inflammation to enter the shoulder resulting in stiffness and worsening pain.

Treatment Options: anti-inflammatory medication, injection, possible arthroscopy or replacement

Subacromial Bursitis

Bursa are fluid filled sacs that reside inside joints all over the body, including the shoulder below a bone called the acromion. These sacs help reduce friction between muscles sliding over bones and can sometimes become inflamed and irritated due to day-to-day use.

Symptoms: The arm may feel weak or painful, especially when it is lifted to the side.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible arthroscopy or cleanup

Rotator Cuff Tendons/Muscles

The rotator cuff is made of four main muscles and associated tendons. These muscles and tendons can tear or avulse (pop off the bone) during physical activity or a traumatic event such as a fall. Chronic wear and overuse can also cause a tear.

Symptoms: Stiffness, pain and weakness of the shoulder are common symptoms as well as feeling a ripping or popping sound during the time of the injury.

Treatment Options: anti-inflammatory medication, physical therapy injection, possible arthroscopy and repair

Biceps Tenosynovitis

The biceps tendon lies within a groove in the front of your shoulder and sweeps in a “windshield wiper” motion across this groove during day-to-day activities. This repetitive motion can irritate the tendon and cause inflammation in the shoulder.

Symptoms: A biceps tendon problem can be associated with pain in the front part of the shoulder. If rubbing or massaging the front shoulder is sensitive or painful, this might be an indication of biceps tenosynovitis.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible tendon reattachment arthroscopically

Treatment options


Anti-Inflammatory Medication– Taking a medication such as Naproxen that reduces inflammation just like you would take a vitamin – twice a day with food and water – is a great way to help the body calm down and allow itself to heal, though this may cause stomach issues as a side effect.

Physical Therapy – Physical therapy is a crucial part in recovery of a tendon tear or rupture. In order to regain motion and strength in the shoulder, one must perform exercises specifically tailored for their injury. Regaining strength takes time, and positive results should start after 4-6 weeks of physical therapy.

Injections – A steroid injection done in-office can help reduce inflammation and calm down the injured joint. Usually, these injections can only be performed every 3-4 months in order to avoid any further damage to the joint. Relief can last anywhere from weeks to months.

Arthroscopy – If you have a large or a small injury and it is not getting better with treatment, minimally invasive arthroscopic surgery might be an option for treatment and repair.

Replacement – Chronic issues such as arthritis might result in the need for replacement. X-Rays, CT scans or MRI should always be performed before moving to surgery.

Do you have joint and muscle pain?

AppOrtho can help. Schedule an appointment with one of our highly skilled providers today.

Don’t leave the mountain for surgery

Don’t leave the mountain for surgery

Advanced orthopedic surgery, close to home


We’ll do everything we can to help you avoid surgery, but it’s good to know our orthopedic surgeons specialize in arthroscopy, total joint replacement, spine, minimally invasive surgery, hand surgery, and advanced knee and shoulder technology. With our anterior hip replacement technique, recovery time has proven to be much shorter. We also offer robotic-assisted knee replacement surgery

Don’t leave the mountain for surgery! We are the only local practice that performs surgery at Watauga Medical Center and Ashe Memorial Hospital. Learn more about AppOrtho >

Sports Medicine Boone, NC

Sports Medicine

Official Sports Medicine Providers for App State Athletics and Watauga High School Athletics

Spine Surgery Boone, NC


More than 25 years experience in non-surgical and minimally invasive surgical techniques

Joint Replacement Surgery Boone, NC

Total Joint Replacement

Total or partial joint replacement, including less-invasive anterior hip replacement technique

Surgery of the neck, shoulder, elbow, wrist, hand, spine, hip, knee, ankle, and foot

All Extremities

We’ve got you covered: neck, shoulder, elbow, wrist, hand, spine, hip, knee, ankle, and foot

Our orthopedic surgery services

Our orthopedic surgery services

At Appalachian Regional Healthcare System (ARHS), we offer an extensive variety of treatment approaches including surgical and non-surgical treatments to your orthopedic injuries and conditions. Our providers are committed to a conservative and non-operative treatment approach first, as they recognize that many injuries and conditions do not require surgery. Nonetheless, non-operative approaches are not always successful or sometimes even indicated. If you must have surgery, you can trust the surgical team at AppOrtho! 


General Orthopedics & Fracture Care (all lower and upper extremity) >

Cartilage Restoration and Preservation (Adults and Pediatrics)

Exertional Compartment Syndrome

Orthopedic Trauma Surgery

Pediatric Sports Medicine Surgery

Sports Medicine Surgery

Tendon Repair & Surgery

Ankle Surgeries >



Tendon repair (Achilles’ tendon)

Wrist Surgeries >



Carpal Tunnel Release (Arthroscopy & Endoscopy)

Fracture ORIF

Ligament repair and reconstruction

Hip Surgeries >

Arthroplasty (Joint replacements)

Arthroscopic Abductor/Gluteal Tear Repairs


Fracture pinning and rodding

Labrum repair


Revision Surgery for Hips & Knees

Total Hip Replacement Surgery

Spine Surgeries >

Anterior Cervical Discectomy and Fusion (ACDF)


Lumbar decompression

Lumbar fusion with cage

Lumbar laminectomies

Lumbar microdiscectomy

Minimally invasive options

Sacro-iliac fusion (minimally invasive)

Elbow Surgeries >




Bicep tendon repair

Cubital tunnel release

Elbow Ligament Reconstruction


Ligament and tendon repairs


Nerve decompression

Nerve transposition


Tennis elbow and Golfers elbow

Knee Surgeries >

ACL, PCL, MCL repair and reconstruction

Arthroplasty (Joint replacement: full, uni-compartmental, and customized

Arthroscopic Meniscus Surgery




Complex Knee Ligament and Tendon Reconstructions

Fracture repair

Medial patellofemoral ligament repair



Partial Knee Replacements (Robotic Assisted)

Patellar Instability Surgery

Removal of loose body

Revision Surgery for Hips & Knees


Tendon rupture repairs

Total & Partial Knee Replacement Surgery

Shoulder Surgeries >


Arthroplasty (Joint replacement)

Arthroscopic Shoulder Rotator Cuff Surgery



Bankart, SLAP repairs



Labrum repair


Removal of loose body

Revision Surgery for Shoulder

Shoulder Instability Surgery

Shoulder manipulation

Shoulder Replacement/Reconstruction

Foot and Toe Surgeries >

Ankle/Foot Fracture Surgery

Bone spur removal


Hammer toe

Ligament repair and reconstruction




Tendon releases (trigger finger) transfers and repairs, tendon sheath reconstruction

Hand and Finger Surgeries >


Complex laceration repair

Contracture release (Dupuytren’s)

Digital nerve repair


External fixators



Fracture closed reductions

Fracture open reductions

Hand Arthritis Surgery

Hand/Wrist Fracture Surgery

Ligament, nerve tendon repair

Scar contracture release (Burns and post traumatic conditions)


Tendon releases (trigger finger) transfers and repairs, tendon sheath reconstruction

Wrist Surgery (Scaphoid/Radius)