Recently, I began performing robotic-assisted knee replacement surgery at our offices and surgical suites in Saint Luke’s Hospital in Kansas City. It’s very exciting to now offer this state-of-the-art technology to our patients at Dickson-Diveley Orthopaedics.
Many patients and referring providers have questions about this type of procedure. Below I’ll answer some of the most common questions I’ve been asked about the surgery, the robotic technology, and how it can potentially benefit people with knee injuries or arthritis.
What system do you use for robotic-assisted knee replacements?
We use Mako® Robotic-Arm Assisted Technology. With the Mako system, I begin by creating a pre-operative plan that is customized to each patient’s specific anatomy and diagnosis. Then, with the help of the robotic arm, I carefully remove damaged bone and cartilage before inserting the joint implant.
What does “robotic-arm assisted” mean? Does a robot perform the surgery?
No, the procedure is performed by the surgeon alone. I am “assisted” by using the robotic arm, which can’t move without my guidance.
How does it work?
First, we do a CT scan, load it into the Mako system and create a 3-D virtual model of the patient’s knee. This model is used like a “map” for me to establish a patient-specific plan for surgery.
During the procedure, I perform the knee replacement in much the same way that it has been done traditionally. I register the computer and knee initially to be able to cross-reference to the preoperative CT scan. An intraoperative plan is then made to identify the ideal position of the implants and the bone removal necessary to achieve that position. The instrument used to remove the ends of the bone is attached to the robotic arm, which can operate only within the parameters that I predefined in the patient-specific plan. Those parameters prevent any excess bone removal or damage to adjacent tissues. I can prepare the bone, insert the implant, and align its components with precision. I can also keep a close eye on the body’s tiniest details through 3-D images, and the Mako system allows me to make adjustments during surgery as needed.
What are the benefits to robotic-assisted surgery as opposed to conventional surgical methods?
Potential benefits of robotic-assisted knee replacement include reduced blood loss and scarring, a lower risk of infection, faster recovery, less discomfort, and fewer complications for the patient. By keeping bone removal to a minimum and precisely placing the implant, the joint operates more smoothly and feels more natural. This can help with our goal to get patients back on their feet and return to normal activities as quickly and safely as possible.
How long has this surgery been available?
According to Stryker, the parent company of Mako, the first Mako procedure was a partial knee replacement in 2006. Since then, more than 83,000 Mako knee and hip replacement procedures have been performed around the world.
Do orthopedic surgeons receive special training for this procedure?
Yes. Like all surgeons who want to perform this type of robotically assisted surgery, I underwent specialized training and received certification from Stryker, the parent company of the Mako technology.
Which patients make good candidates for robotic-assisted knee replacements?
Robotic-assisted surgery may be an option for people who are considering a partial or total knee replacement due to arthritis or an injury. Talk to an orthopedic knee specialist for more information about eligibility for this procedure.
About the Author
Scott A. Wingerter, M.D., Ph.D. is a board-certified and fellowship-trained orthopedic surgeon specializing in joint preservation and replacement surgery. His focus is on total joint replacement of the hip and knee, hip resurfacing, partial knee replacement, minimally invasive surgery, and hip arthroscopy.
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