Robotics Transforms Knee Replacement Surgery: Technology Allows for Ultraprecise, Customized Procedure

Over the past two decades, I have seen many advances in joint replacement surgery that have benefited patients. I believe robotic-assisted knee replacement, which allows for an ultra-precise procedure, is one of the most exciting. 

I recently reached a milestone when I performed my 500th robotic-assisted knee replacement. I use the MAKO robotic system, which is FDA-approved for both total and partial knee replacements.

Joint replacement is highly successful in relieving arthritis pain and improving quality of life, and robotic system allows us to really customize the procedure for each patient. The MAKO system allows for optimal alignment and positioning of the knee implant, as well as optimal ligament balancing, all critically important for the best outcome and long-term success of the surgery. Such precision could potentially lead to a longer-lasting knee replacement.

Over the past few years, I've seen more patients in their 40s and 50s with arthritis. The main concern for patients in this age group is that the implant may wear out over time. Although a knee replacement could last 20 years, or even longer, it doesn’t last indefinitely. For younger individuals in particular, robotic-assisted surgery has made joint replacement an attractive option, as it could prolong the life of the implant.

More recently, studies have focused on the pinpoint accuracy of the robotic-assisted knee replacement system. A study we conducted at Hospital for Special Surgery published in the Journal of Knee Surgery last year found that the technology was advantageous in the training of orthopedic surgeons, as it allowed for increased accuracy and precision.

A separate study in the Bone & Joint Journal in 2018 by researchers in the United Kingdom found robotic-assisted total knee replacement was associated with decreased pain after surgery, improved early functional recovery and a shorter hospital stay.

Before surgery, a CT scan is taken of the patient’s knee. The scan is then uploaded into the Mako system software, where a 3D model of the joint is be created. The 3D model is used to plan and assist in performing the joint replacement.

In the operating room, the orthopedic surgeon controls a robotic arm that uses computer‐guided mapping software, similar to GPS, integrated into the surgical instruments to position the implant in the knee joint.

The digital tracking system constantly monitors and updates the patient’s anatomy and enables the surgeon to make real‐time adjustments to optimize implant placement, alignment, ligament balance and joint motion. This provides each patient with a personalized surgery tailored to his or her individual anatomy.

With more accurate alignment and positioning, the implant should experience less wear and friction, and it could ultimately last longer. Studies will be needed to confirm this over the long term.

The precision of the robotic‐assisted procedure also offers more protection to the surrounding soft tissues and enables more healthy bone to be preserved, an advantage in the event another knee replacement is needed down the road.

For more information, visit my website.

Comments

Post a Comment

Popular posts from this blog

A Steroid Injection for Bone-on-Bone Arthritis? Not So Fast!

Image
Sometimes, arthritis gets so bad that nothing seems to help, and people decide they are ready for joint replacement surgery. When that time comes, some patients are surprised to learn they will have to wait a few months because they recently had an injection of a steroid or hyaluronic acid. Waiting is not the only issue. The injections do little to relieve pain when someone has bone-on-bone arthritis and is a candidate for joint replacement. If there is any pain relief at all, it is very short-lived, and most patients are very disappointed. The other issue is that patients who receive a steroid or hyaluronic acid injection should wait approximately three months from the date of their last injection to have a hip or knee replacement. This is because studies have demonstrated an increased risk of infection in the first three months following these injections.   When elective surgeries resumed after the pandemic pause, I saw five patients over a two-week period whose joint replacement
Read more

“Dual Mobility” Hip Replacement Does Double Duty: Relieves Pain and Reduces Risk of Dislocation

Image
Hip replacement to relieve arthritis pain is considered one of the most effective surgeries in the United States. Over the past decade, improvements in surgical technique, implant design, anesthesia and pain control after surgery have contributed to its success, says Geoffrey Westrich, MD, an orthopedic surgeon at Hospital for Special Surgery (HSS).  More than 450,000 total hip replacements are performed each year in the United States, according to the Agency for Healthcare Research and Quality. One of the most noteworthy advances is what’s known as a “dual mobility” hip replacement, according to Dr. Westrich, who has conducted several studies on the implant. He and colleagues have found that the dual mobility prosthesis reduces the risk of dislocation, one of the most common complications after hip replacement surgery. While the incidence is less than 2% at Hospital for Special Surgery and other major joint replacement centers, it is significantly higher at some other locations.   “Du
Read more