A New Frontier For Knee Replacement
In the past, knee replacements happened through open surgery, consisting of 1 or 2 large incisions. As time progressed, doctors created minimally invasive techniques. Doctors can now replace the knee with buttonhole incisions using a high-powered, snake-like camera and other small tools. Minimally invasive surgery continues to be the gold standard. However, a few hospitals around the country have adopted robotic knee replacement. This innovative approach is the future of knee replacement and surgery at large. But is the recovery time any better than other surgeries?
How Robotics And Surgery Go Hand
With robotic-assisted surgery, a mechanical arm with special tools at the end helps the doctor perform the surgery. The robotic arm combines 3D imaging technology and infrared to map out the best replacement for the patient. The doctor can then perform the surgery with robot-assisted guidance. The robot arm does not act independently but is an extension of the surgeons capabilities. However, hospitals and clinics with the resources to invest in the use of advanced surgical practices have seen a great return on their investment. Furthermore, patients receive both direct and indirect advantages.
Mako Total Knee Replacement Surgery Introduction
The Mako Robotic Total Knee System is a highly advanced, consistently, reproducible, precision joint replacement installation system for patients with knee arthritis too advanced for Mako Partial Knee replacement. Dr. Buechel is an expert user of the Mako Robotic Knee system and has an international surgical experience of over 1,500 Mako Robotic knee procedures operating on people from around the world. Dr. Buechel understands which patients are best suited for Partial Knee replacement and which patients knee arthritis is too advanced and will benefit from Mako Total Knee replacement.
Dr. Buechels vast robotic experience allows him to optimize each persons knee implant installation, utilizing all the tools provided by Mako Total Knee to improve the implants position, balance, function & longevity, while creating the most natural feel for the patient.
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Navio By Smith & Nephew
The NAVIO Surgical System also uses robotic-assisted technology to assist with total knee replacement procedures. Rather than using preoperative CT-scans, bone mapping is achieved during the operation to yield a 3D representation of the bone structure. This software model is used by the surgeon to virtually position the implant and balance tissues prior to cutting bone. The surgeon then uses a robotics-assisted hand tool to guide the procedure based on the bone mapping. The NAVIO Surgical System received 510 clearance from the FDA in April 2018.
Smith & Nephew recently collaborated with Osso VR, a surgical training company, to create a module for the NAVIO Surgical System. This module is designed to be used by practicing surgeons and residents who are learning the robotics-assisted procedure and involves clinically supported virtual reality simulations of the procedure.
Dr. Cyril Kruse, Medical Director of Orthopedic Surgery at Unity and Mercy Hospitals, evaluated both the Mako and NAVIO systems and prefers NAVIO for both its precision and the fact that patients do not need to undergo CT scans. He notes that the CT scan is not only a time-consuming and costly procedure, but it exposes patients to harmful radiation as well.
Stryker Triathlon Implant Installation And Verification
The Stryker Trial implants are installed without cement to test the tracking, tension and stability of the knee joint. The computer software allows a review of the alignment, ligament gaps and balance. Adjustments can be made to the soft tissues or through secondary robotic guided bone cuts to optimize any of the parameters to provide the most stable well aligned knee possible.
Once optimal conditions are confirmed with the trials in place, the final implants are opened prepared to be attached to the knee.
The final implants are installed with or without the use of bone cement, attaching them to the femoral, tibial and patella bones. Probes can be used to verify the precise seating of the implants at their planned locations on the bone.
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What Led To Mako Knee Surgery
In 2005, two unrelated events occurred leading up to the development of Mako Knee Surgery. First, modern robotic technology was made available to many physicians and surgeons. Second, the rise of minimally invasive knee surgery provided them with a new option for treating knee problems. Some researchers believed that the robotic arm would be best used for minimally invasive surgical procedures.
However, it was soon realized that robotics would not offer the precision and accuracy of traditional surgery.
To overcome this difficulty, researchers began using automated systems to allow a surgeon to use a 3-D CT scan to guide them in performing a procedure. The new system significantly improved the chances of success without compromising on quality. Today, there are several different types of automated systems that surgeons can use.
What Happens During Computer Assisted Knee Replacement
In knee replacement surgery, the arthritic portion of the knee is taken out. This is then covered with a combination of plastic and metal parts that form the new surfaces of the knee joint.
During Robotic Orthopedic Surgery for knee replacement, surgeons use a computed tomography scans to build a virtual model of the patients knee. With that model as a guide, the surgeon then uses the robotic arm to embed the components of the new knee precisely.
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Choose Whats Right For You
Knee surgery may be necessary to get some much-needed relief. Luckily, different surgical options can help. Robotic surgery has some fantastic advantages over traditional procedures, such as quick surgeries, reduced infections, and faster recovery. However, traditional surgery can still be effective in certain situations. Speak with a doctor about the possibility of robotic knee surgery today.
Spire Busheys Commitment To Orthopaedic Excellence
Working with leading consultants in their field, we have become the private hospital of choice for knee replacements in London and our region. Across both 2016 and 2017*, more knee replacements were carried out at Spire Bushey than any other private London hospital.
Spire Bushey is leading the way in orthopaedic surgery and has been selected by industry experts Smith & Nephew to be the first hospital in Europe to offer this pioneering new system. This cutting edge technology has already been used successfully in the US to the benefit of many patients.
Our team of expert physiotherapists provide comprehensive pre-habilitation programmes to help strengthen the limb before surgery to improve recovery. They use the onsite gym and hydrotherapy pool to support patient rehabilitation following surgery.
We offer fast access to appointments, which are available 7 days a week.
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What Is The Difference Betweenrobotic
First of all, robotic-assisted total kneereplacement is not performed by a robot. Your surgeon is still in control ofthe surgery. You can think of the robotic system as another surgical instrumentto help your surgeon get the job done better.
At Phoenix Spine & Joint, we use roboticassistance for all of our total knee replacements. With this system, oursurgeons can make more precise incisions, remove damaged cartilage moreaccurately, and select the perfect size for your new artificial joint.
Traditional total knee replacement surgeriescan still help reduce your pain and improve your quality of life. Although,without the enhancement of robotic-assistive technology, your surgeon may notbe able to perform to their fullest potential. This may result in subparalignment of the knee after the surgery.
Managing Your Recovery At Home
To begin with, its normal to experience:
- tiredness get plenty of rest, but then its important to slowly increase your activity
- swelling to ease this, keep your leg raised when sitting and use the cryocuff cold compress we gave you, or apply an ice pack wrapped in a tea towel
- pain take any painkillers weve prescribed until youre pain free
Here are a few things you can do to strengthen your knee, avoid damaging it and help your wound heal:
- Keep your wound dry for 45 days afterwards, and use a waterproof dressing when you have a bath or shower
- Continue the exercises the physiotherapist showed you
- Try low-impact activities like walking and gradually increase how far you walk
- Keep using your crutches or walking stick for as long as you feel you need to
- Dont lift anything heavy or do any strenuous exercise
- Youll be able to bend your knee 90-120 degrees, but you should avoid kneeling down
- Dont sit with your legs crossed for the first 6 weeks
- Avoid twisting at your knee
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What Is A Knee Replacement
A knee replacement is carried out to treat knee pain, usually due to knee osteoarthritis, which is gradual wear and tear of the joint. Arthritis accounts for the majority of the 90,000 knee replacements carried out in England and Wales annually.
During the procedure, both sides of the damaged joint are removed and replaced with a prosthesis or implant. If your arthritis is minimal, and youre under 65, you may be able to have a partial knee replacement. With this procedure the surgeon only replaces the damaged compartment, which means that the knee tends to bend better and feel more like a normal knee than after a partial knee replacement than it would with a total knee replacement. Your surgeon will recommend the surgery thats best for you, depending on your symptoms and X-ray results.
Difference Between Traditional Knee Replacement And Mako Knee Surgery
Traditional knee replacement is invasive and involves making significant cuts in both your thigh and calf muscles. It typically takes multiple days to finish this type of surgery due to the need for rest between each procedure.
Unlike traditional surgery, this type of procedure can be completed during one visit, and you will not need to stay in the hospital overnight. Also, there are no major incisions or cuts required in your muscles. Your doctor will use robotic arms and other minimally invasive techniques to perform robotic assisted surgery on you. It will significantly reduce the amount of bruising, swelling, and risk of infection that you experience.
Also, as noted earlier, it is a minimally invasive procedure used for replacing knee parts. It is performed using robotic arms guided by a computer to ensure accuracy during the process. After this type of surgery, the recovery time can range from several weeks to just a few weeks.
Using this procedure a surgeon takes a 3-D scan of the patientâs knee. This scan then creates an image that allows them to plan what joints need to be repaired and replaced.
The surgeon will cut away pieces of your damaged cartilage and insert new pieces of plastic or metal into their place. This can be done with minimal trauma to your muscles and tissue. The robot is then used to position the implants precisely in their proper place.
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How Robotic Surgery Changes The Game
The medical field created robotic arm-assisted surgery to improve the accuracy of resurfacing and installing components. The concept originated from the robotic arms used in automotive manufacturing, which needs to be precise. Robotic surgery is performed with a device on wheels that has a long mechanical arm attached. At the end of the robotic arm are set tools and implants for the new knee hardware. The device combines infrared and 3D technology to get a scan of the knee beforehand. These images allow the surgeon to position and balance the implants with exceptional accuracy. From there, the robotic arm guides the surgeon to install the components of the knee.
Tracking Arrays & Registration
During the procedure, Dr. Buechel places temporary infrared tracking devices called Arrays, on the femur and tibia. These allow the computer to see the bones moving in the operating room, know the exact position of the robot with its cutting tool, and match the precise location of the bone of the patient to the 3D CT scan plan in the computer. This process is called Registration.
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Customized Replacements For Each Patient
One of the challenges for surgeons is the installation of prosthetics. Each patients knee is shaped differently, if only by a few millimeters. The surgeon must remove enough cartilage, get the size correct, and install the prosthetic in the right spot. Robotic surgery helps this process significantly. The robot first maps out a 3D image of the knee and prosthetic down to the nearest millimeter. This step gives each patient a prosthetic thats fitted to the exact specifications. As a result, patients will have less post-operative pain and a longer-lasting prosthetic.
More Information Means Better Outcomes
Mako Robotic-Assisted Joint Replacement gives surgeons more information during the procedure, which means you get better results. For example, heres how a knee replacement works:
- Your surgeon makes a small cut in your knee to expose your knee joint.
- Using the Mako robotic software, theyre able to see how your joint moves.
- This allows the surgeon to align the joint precisely and balance the ligaments.
Because Mako technology gives your surgeon greater precision, you get a more natural-feeling joint. And, because your surgeon can see in advance how a particular cut will affect your joint and surrounding structures, they don’t have to make additional cuts to get that balance right. This means less trauma for you during surgery and a faster, more accurate procedure with a more predictable outcome.
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Robotic Knee Surgery Advantages Disadvantages Recovery Time
Anyone suffering from knee pain knows that it can stop you doing the things that you love, spending time with loved ones or even getting out of a chair or vehicle. Alongside this, sufferers of knee pain will also know that surgery is an option for them. Traditional knee operations such as those like partial knee replacements can mean a sizeable stay in hospital of at least seven days and a convalescence period of up to two months.
The alternative, therefore, is Robotic Knee Surgery, which can make convalescence timeless lengthy and be entirely more beneficial than that of a traditional knee replacement. This is mainly an option when more traditional methods of treatment havent worked such as physiotherapy and are particularly effective for individuals that suffer from arthritis that only affects up to two of the compartments of the knee.
Knee Replacement Recovery Exercises
Initially, as you increase your activity the knee can be sore, but with appropriate medication and gentle exercise, your recovery should proceed smoothly.
Well prescribe a set of exercises for you to do at home. Every programme is different, but here are a few exercises we regularly ask patients to do. You should aim for 3 sets of 10 reps per exercise every day:
- Stair lunges: Stand at the base of the stairs and place your operated foot on the first stair. Lunge forward slowly bending at the knee only as far as is comfortable
- Bed exercise: Push the knee flat into the bed to fully straighten the leg
- Mini-squats: Stabilise yourself by holding on to a kitchen bench, door frame or heavy table. Keeping your back straight, lower you buttocks bending, at the knees. Only go as far as is comfortable.
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Robotics Brings Groundbreaking Efficiency
With the technology, robotics became a useful part of minimally invasive knee surgery. Using CT scans and 3-D technology, the devices creates a digital replica of the prosthetics. The machine also provides the exact installation location of the new joint. These simple additions improves the speed of surgery. The robotic arm can also help with errors, improving the accuracy for new and experienced surgeons. Open surgery tends to be a longer operation due to larger incisions and blood loss. Theres also a possibility of setting the prosthetics with a slight error, which can prolong healing.
What Are The Cons Of Robotic Knee Replacement Surgery
Robotic assisted knee replacement is relatively new technology, particularly in performing total knee replacements, so although the clinical studies performed so far are encouraging, more longer-term studies are needed.
The procedure takes slightly longer to perform than a conventional joint replacement so the risk of infection could be slightly increased, although to what amount is uncertain at present.
More importantly, by leaning harder on a computerised system, some surgeons have already pointed out that any system is only as good as the data it uses and the people who process it, meaning that the quality of the scans used need to be of the highest quality and extra time and resources are going to have to be funnelled into the training of staff to get the optimal effects with the Mako system.
The cost of the procedure is also slightly more than a conventional joint replacement because a CT scan is required of the joint to plan the procedure.
For more advice on the pros and cons of Mako robotic knee replacement, call to arrange a consultation at my Bristol clinic or for my London knee clinic.
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Procedure For Robotic Knee Replacement Surgery
Here the surgeon uses the handheld robotics to shape the surrounding bone before placing the knee implant. A 3D representation of knee profile is created which is used by the surgeon to determine the size and position of the implant. The results of this surgery are more accurate and reliable as it is possible to target only the damaged bone with exact precision. It assists both in partial and total knee replacement.
Driving After A Knee Replacement
You should be able to start driving again after about 68 weeks, as long as you can operate the pedals and control your car in all situations. Any earlier than this and your reaction times may be too slow, particularly for emergency stops. Always check with your insurance company and your doctor first.
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