A new surgical procedure allows docs to do an operation virtually — on the computer of a robot — before the patient even comes into the OR.
In the past, many adults suffering from orthopedic maladies like osteoarthritis on part of their knee were discouraged from pursuing certain surgeries, such as partial-knee replacements, due to their high rate of failure attributed to a surgeon’s lack of visualization. But that is quickly changing, as Lafayette General Medical Center now has a new cutting-edge technology to aid its orthopedic surgeons in the delicate art of hip and knee replacement.
MAKOplasty is a minimally invasive procedure for adults suffering from early to mid-stage osteoarthritis; it uses a highly advanced, surgeoncontrolled robotic system that enables ultra-precise alignment and placement of implants in patients undergoing partial knee or total hip replacement. MAKO also features the Robotic Arm Interactive Orthopedic System, or RIO, that makes treatment less invasive than traditional surgery, which helps improve outcomes.
“Historically, I’ve discouraged patients from utilizing partial knee replacements because of the high incidence of failure, but with this technology, it is back on the table as a very viable option on patients that have focal arthritis on only one aspect of the knee,” says Dr. Scott Yerger, a local orthopedic surgeon and medical director of LGMC’s total joint sub-speciality. LGMC is the first hospital in Acadiana to offer the treatment.
The RIO System uses CT scans of each patient’s hip or knee to assist surgeons in pre-planning their surgery. During surgery, a robotic arm uses computer-guided mapping software, similar to GPS, integrated into the surgical instruments to ensure exactness within one millimeter of accuracy. This gives each patient a surgery customized to his or her individual anatomy.
“We’re able to accurately and precisely gauge where we need to position the acetabular, or socket component, of the hip for optimum performance, which lowers the incidence of complications such as dislocation and wear of the bearing surface,” explains Yerger. “And then the next big benefit is it lets us accurately gauge the leg length measurements to more accurately reproduce the patient’s leg lengths to get them exact.”
MAKO also offers partial resurfacing, which can be a vital option for younger adults suffering from knee pain whose doctors often discourage full replacement. The MAKO procedure gives patients a quick recovery alternative that can potentially eliminate years of prolonged pain until full replacement surgery becomes necessary.
“We’re doing it through a very, very small incision of only about 2 to 3 inches in length, and by doing that the patients have less pain,” says Yerger. “They’re actually at a high level of function within two to six weeks and they’re getting back to work at an earlier point and time as well.”
With the aid of this machine, a surgeon can devote more attention to detail so that the replacement lasts much longer than before, allowing the implant to experience less wear and tear, which means partial replacement becomes viable for people of younger ages and also makes fewer replacements necessary for elderly patients.
MAKOplasty also has a number of potential benefits over traditional knee and hip surgeries, including reduced pain, minimal hospitalization, shorter recovery time, less implant wear and loosening, smaller scars and overall better motion to promote a more natural feeling knee.
According to Yerger, MAKO allows orthopedic surgeons like himself to color inside the lines.
“What it allows us to do is not vary outside the lines or outside the parameters,” says Yerger. “We don’t go too deep and we don’t go too far in one direction or the other in the patient’s final positioning so that we get an exact replica, intraoperatively, of what we wanted it to be preoperatively, which is fascinating technology. We basically do the operation virtually on the computer of the robot before the patient even comes into the room.”