Healthbeat Report: A Robotic Twist on Knee Surgery

June 10, 2011 10:39:06 AM PDT
A day playing golf is a day osteoarthritis patient Herb Williams has been waiting a long time for. The lifelong athlete is just getting back into the swing of things after years of enduring painful osteoarthritis of the knee.

"The pain became more constant and aching, and you just wanted relief," said Williams.

His doctor suggested partial knee replacement with a robotic twist. Makoplasty combines 3D images of the patients knee with a GPS-like technology. The idea is to make the surgery more precise.

"It uses a robotic arm that's connected to a high-speed burr to help remove only the diseased portion of the knee and allow for a quicker recovery with a more natural-feeling knee," said Dr. Andrew Noble, orthopedic surgeon, Palm Beach Orthopaedic Institute.

After getting a CT scan, a plan is mapped out based on what part of the knee needs to be removed. A 3D image is created and given to the robot. It allows the surgeon's instrument to only go within the area of the bone that needs to be removed.

Hinsdale Orthopedics has been offering makoplasty since October. Demonstrating on a model knee, orthopedic surgeon Michael Durkin says they've have had good success so far. Patients are up and around faster, and he says the system helps create a more natural feeling implant that should wear better over time.

"Three to three and a half times more accurate in terms of positioning the components which then leads to better functioning of the knee and better long term results," said Dr. Durkin.

Susan Gross had her right knee done in December with the newer technology.

"I recovered, I felt, very quickly," she said.

But not everyone is sold yet on this robotic approach.

Doctors at Rush University Medical Center are not using makoplasty. Orthopedic surgeon Craig Della Valle says it makes sense intuitively but adds time and expense to the surgery. And he says there still needs to be long term proof it's really better.

"I do think it is doing what it is supposed to do, but we have to figure out is that going to lead to better outcomes or longer durability for the patient," said Dr. Della Valle.

Just five weeks after surgery and Herb Williams is convinced.

And even as studies are on going some doctors are already talking about makoplasty for full knee replacements and hip surgery as well.

"I think this kind of technology will be here to stay and will definitely change the way we do these procedures in the future," said Dr. Noble.

Many doctors support a national registry of orthopedic patients to evaluate the long term progress of implants including this one. The partial knee resurfacing is designed for those with early to mid-stage osteoarthritis that is localized to one area of the knee.

Most patients recover in weeks versus total knee replacement surgery, which can take months.

Hinsdale Orthopaedics


Adventist Hinsdale Hospital
120 North Oak Street
Hinsdale, IL 60521
(630) 856-9000

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