Bipolar Sealer Aquamantys Use in Total Knee Replacement

Inclusion Criteria: * Patient is ≥18 years of age * Patient has failed conservative therapy of osteoarthritis of the knee and has been listed to undergo primary TKA * Patient is willing and able to provide written informed consent. * Pre-assessment Haemoglobin ≥ 11.0g/dl * Patient is suitable to receive spinal anaesthesia with no peripheral nerve blocks * Patients willing to undergo blood transfusion Exclusion Criteria: * Patients that are listed for unicondylar or revision TKA * Patients who are being converted from a previous high tibial osteotomy and a previous unicondylar knee arthroplasty * Fixed motor deficit thus affecting functional assessment of the knee * Patients presenting with a non-osteoarthritis degenerative knee diagnosis * Patients presenting with known contralateral knee osteoarthritis requiring simultaneous bilateral TKA * Patients presenting with a history of previous knee infection * Patients presenting with a pre-operative knee range of motion \< 85° * Knee deformity greater than 20 degrees varus or valgus * Patients presenting with a history of bleeding disorders and/or are on chronic blood anticoagulation therapy * Patients with significantly impaired renal function (defined by EGFR \>30) * Patients with allergy or sensitivity to non-steroidal anti-inflammatory drugs, ropivacaine, ketoprofen or adrenaline * Patients presenting with an internal cardiac defibrillator * Women who are pregnant * Evidence of active (systemic or local) infection at time of surgery * Patients who have habitual opioid use * Patients who have a psychiatric or mental illness which could impair the consent process or ability to complete patient-report questionnaires * Morbid obesity \[BMI \> 40\] * Patients who are unwilling to undergo blood transfusion, if necessary * Patients who are receiving any implant used in conjunction with a customised-cutting block system * Any patient who cannot or will not provide written informed consent for participation in the study * Those whose prospects for a recovery to independent mobility would be compromised by known coexistent, medical problems