What Does The Procedure Involve
Your surgeon will use Mako to make a 3-D virtual model of your knee. He or she will then virtually put the implant in place, and once its in the proper position, this plan can be implemented during surgery.
As youre under general anesthesia, Makos robot arm, along with the doctor, will hold the surgical instrument. Your surgeon will be able to see the pre-surgical plan overlaid on the real-time surgery to use as a guide, and the instruments are under his or her control the entire time.
The robotic instrument has tracking eyes and can adjust for very small movements of the knee if they occur. It precisely prepares the bone according to visual boundaries that protect the essential structure of the knee and removes only the part thats been affected. The implant is placed, the joint is properly balanced, and if necessary, your surgeon can make adjustments if needed.
The Benefits Of Dr Buechels Mako Robotic Total Knee Replacement Surgery
The Mako Total Knee System empowers Dr. Buechel with more information, more accurate information, and live dynamic information about size, alignment and balance to make better surgical decisions than with conventional tool systems alone. Optimizing ligament balance, implant position and leg alignment using precision software while making precise, safe bone cuts with the robotic arm assistance benefits each patient by providing them with a customized installation. This translates to a more precisely placed knee replacement optimized for each individuals personal characteristics producing a more comfortably functioning knee.
Ial Knee Replacement Surgery & Robotic Partial Knee Replacement Surgery In Dubai At Cmc
A partial knee replacement, also known as unicompartmental knee replacement, is a surgical procedure that is used to replace only one part of a damaged knee. The technique, which is used as an alternative to total knee replacement, is used as a treat option for individuals with joint disease resulting from degenerative and post-traumatic arthritis that is limited to one side of the knee.
Ideal Candidate for Partial Knee Replacement
For one to be considered for partial knee replacement procedure, he/she should fit certain criteria. These include:
- Individuals with medial , or lateral knee osteoarthritis.
- Before undergoing the procedure, it must be confirmed that the patient has a stable knee, an intact anterior cruciate ligament, and enough range of motion in the knee.
- Patients whose knee pain persists even after using anti-inflammatory medications and maintaining a healthy weight.
Benefits of Partial Knee Replacement
- Faster rehabilitation and recovery
- Improved range of motion in the knee
- Preservation of all healthy bone and ligaments
Why Partial Knee Replacement is Recommended
The most frequent justification for replacing a knee joint is to relieve severe pain. However, the orthopedic surgeon may recommend a partial knee replacement if the patient is experiencing the following:
- Persistent knee pain even after other treatments
- The pain interferes with the patients daily activities
- The knee pain interferes with the patients quality of life like inability to sleep
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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.
What Do These Differences Mean
Pre-operative CT scans are not a standard requirement for knee replacements, this represents an extra step for the patient, the surgeon and the healthcare system. This extra procedure can cost patients additional time, money and exposure to radiation.
Navio partial knee replacement has an open approach to implant selection which makes available more choices for surgeons to use. The technology provides a collaborative approach to solving joint pain and returning patients to more normal function.
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Problems With Robotic Knee Surgery
An incorrect alignment is likely to result in abnormal wear, early mechanical loosening, and wear problems with the patellofemoral joints. With the advancement of robotic assistance, total knee arthroplasty has seen an increase in popularity in recent years.
A robotic-assisted total knee arthroplasty procedure costs 26% more than a traditional one. Despite this, patients spend less time in the hospital and are less likely to have complications. Researchers looked at 1,285 robotic TKA procedures and 3,930 traditional TKA procedures from a retrospective perspective. A new study provides further evidence that robotic orthopedic surgery does not harm patients. There is no difference in functional scores between robotic and nonrobotic patients at the start of the study. Confusion arose as a result of demographic or follow-up factors. According to a study, hospitals should carefully consider the financial impact of robotic surgery.
What Is Makoplasty Surgery
MAKOplasty surgery, in general, is a type of surgical procedure that allows surgeons to perform complex surgical procedures while circumventing the limitations of traditional and minimally-invasive surgery. Robotics enhance the surgeons skills with advanced control, flexibility and precision. Robotic surgery or robotic-arm-assisted surgery for MAKOplasty, allows Dr. Martin to perform a total hip replacement, total knee replacement, and partial knee replacement with these benefits.
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Quick Stats And Facts About Knee Replacements
- The first knee replacement was performed in 1968.
- Its estimated that by the year 2040, more than 78 million U.S. adults will be diagnosed with arthritis of the knee. Thats over a quarter of the U.S. adult population.
- Around 15% of all patients suffering from knee arthritis can be treated with a partial knee replacement.
- Maintaining a healthy lifestyle can significantly help in relieving joint pain.
Clinical Indications For Mako Total Knee
The clinical indication to proceed with Mako Robotic Total Knee is determined by a proper diagnosis, an appropriate medical and knee history, Dr. Buechels examination that confirms the findings and evaluates the patients condition, and imaging studies that support these conclusions. The most common reason for knee replacement surgery is osteoarthritis. Other reasons include: arthritis after meniscectomy, post-traumatic arthritis, osteonecrosis, inflammatory arthritis, osteo-chondral defects, and failed cartilage restoration procedures.
There are a few reasons that Dr. Buechel and other surgeons would recommend against a knee replacement which can include infection history in the knee, some severe deformities or congenital problems, neurologic conditions that make the muscles unable to support the knee, skin problems that can compromise wound healing, some extreme weight conditions, and medical conditions that create too high of a risk for complications.
Also Check: Can You Have More Than One Knee Replacement
Advantages Over Other Systems
The advantages of less invasive surgery are:
- To allow quicker rehabilitation of the knee due to the decreased soft tissue and bony trauma.
- There is also less bleeding which can lead to less swelling and less pain, which contributes to the quicker rehabilitation.
- A greater range of motion can be achieved compared to a conventional approach. There is a potentially quicker return to function.
Taking all the above into account, a potential quicker return to function can be achieved, resulting in a shorter length of stay in the hospital of between 1 to 3 days.
My patients who undergo knee replacement surgery follow an accelerated rehabilitation programme which commences on the day of surgery. This includes use of a CPM machine, immediate range of motion exercises, quadriceps strengthening, hyper-extension stretching and early walking . This is combined with a specific and effective pain-relieving drug regime devised by Professor Jari which he has been successfully using with his patient for many years.
Chapter : Transition To A Hand
Disruptive technologies bring to a market a very different value proposition than had been available previouslyProducts based on disruptive technologies are typically cheaper, simpler, smaller, and, frequently, more convenient to use.
Erik Brynjolfsson and Andrew McAfee
In November 2007, I was listening to a lecture at an Innovators Conference in Pittsburgh, PA given by the CEO of a start-up named Blue Belt Technologies. It was then that I was presented with the prospect that robotic UKA surgery had the potential to be done without a pre-operative CT scan using a device in development that was considerably less expensive, smaller, and more portable than its predecessor. His presentation dealt primarily with funding considerations for tech start-ups, but I was intrigued by his companys pre-clinical technology – a novel handheld robotic sculpting tool developed by Dr. Tony Digioia and Branko Jaramaz for use in UKA. Afterwards, we spoke extensively about their device, a relatively crude prototype at this stage, that was barely bigger than an arthroscopic shaver. The tool provided a safety mechanism by modulating the speed or exposure of a motorized bur to avoid inadvertent bone resection beyond the plan, and all of the surface mapping was performed intra-operatively without the need for a pre-operative CT scan. It was highly portable which meant it would be more conducive to staggering cases between two operating rooms than the larger Mako unit. Its potential intrigued me.
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Chapter : First Foray Into Robotics
The robotics industry today is where the PC industry was 30 years ago.Bill Gates
In 2006, I had the good fortune of being introduced to the engineer-inventor behind the Mako technology. His team developed a CT-based, haptically-guided robotic arm in the heat of south Florida for use in UKA to help improve accuracy of bone preparation and quantify soft tissue balance. The goal was to eliminate error and with it the expectation that it would enhance function, improve durability, and optimize surgical efficiency. Soon thereafter, I tried out the Mako® robot in a cadaver lab in Newark, NJ, and was immediately hooked on the potential of the surgical tool. The registration process at that time was a little bit time consuming, and the early generation product was admittedly crude by todays standards, but immediately I was drawn to the precision with which bone could be removed and prepared with a five or six mm spherical bur, and was confident that Mako would improve and modernize the early features. That moment began my interest in robotics for UKA. I wanted one, and I believed immediately that it would make me a better UKA surgeon.
Is Mako An Option For Me
Mako Total Knee is for people with:
Severe knee pain or stiffness resulting from: noninflammatory degenerative joint disease , rheumatoid arthritis or post-traumatic arthritis
Those who havent experienced adequate relief with conservative treatment options, like bracing, medication or joint fluid supplements
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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.
Wound Closure & Healing Optimization
Dr. Buechel is focused on optimizing wound healing for all of his surgical patients. Therefore, he has recommendations on the entire process from before surgery, to after surgery to enhance wound healing and recovery.
Patients should optimize their preoperative nutrition and exercise, while eliminating or minimizing any risk factors for poor wound healing such as smoking, excessive alcohol intake, poor blood sugar control or excessive Body Mass Index which all can lead to greater complications after surgery. Immuno-nutrition products such as Ricochet drinks help optimize each patients nutritional status for elective surgery. Proper protein and nutritional intake before and after surgery has been shown to improve wound healing and reduce the risk of infection.
During the procedure, Dr. Buechel meticulously cares for the health of the skin and deep tissues throughout the procedure while exposing, retracting, and closing the knee joint, to optimize healing, minimize blood loss, and reduce the incidence of wound healing problems.
A cosmetically appealing scar is common after Dr. Buechels procedures because of the variety of techniques he employs during the surgery, and the carefully chosen products he uses for the closure and aftercare. The highest quality suture is used to hold the tissues longer and stronger, while providing anti-bacterial protection. Stratafix Plus barbed antimicrobial suture is our preferred suture.
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What Tests Will Be Performed Before Surgery
To ensure that your body is healthy and ready for surgery, your physician will perform a physical checkup and order routine blood work and urine tests. An EKG and chest X-ray may be necessary if you are over 50 or have a history of heart or respiratory issues.
Other tests may be conducted depending on your specific medical conditions.
Open Versus Closed Platforms
The majority of available robotic systems in the US are regarded as closed platforms. Closed platform systems are only compatible with specific vendor implants.47 This may hinder some surgeons in adopting robotic technology if they have a preference towards an implant that does not have a robotic platform. Open platform systems are more appealing due to accommodation of a wide variety of prosthesis designs from multiple different manufacturers. Although open platforms provide a convenience for incorporated 3D implant data for numerous implant systems, they may lack the depth of biomechanical kinematic data present in closed platforms that use proprietary implants.56 Currently, TSolution-One is the only RA-TKA system on the market with an open platform.56
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How Do You Treat Arthritis In The Knee
Knee arthritis is initially treated with non-surgical techniques. All of these modalities do not repair or replace the damaged cartilage but rather just control the inflammation in the knee. Modalities range from anti-inflammatory agents such as MotrinÂ®, CelebrexÂ® or VoltarenÂ® to injections of Hyaluronic acid or Steroids. When the symptoms are mild these are the first line of treatment. Physical therapy also will help a knee early on in the disease process. Newer treatment options such as PRP or stem cell injections also may work and are good options to consider initially while recognizing these treatments dont repair or regenerate the lost cartilage. Therefore, when the non-surgical options have been exhausted or if there are medical reasons that prevent the usage of the non-surgical modalities, partial or total knee replacement may be the best option.
Robotic Surgery: The Pros And Cons
Modern robotic surgery has come a long way since its inception several decades ago, and it has many advantages over traditional surgery. There are numerous advantages to using this method, including increased surgical precision, less pain, shorter hospital stays, and faster recovery. Although robotic surgery presents its own set of disadvantages, such as complications caused by the robotic system, such as pin-hole fractures, pin-related infections, iatrogenic soft tissue and bony injuries, and excessive blood loss, it is still a viable option. Despite patient dissatisfaction rates ranging from 82 to 89%, robotic surgery continues to improve and is expected to remain so for some time to come.
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Minimally Invasive And Robotic
Minimally invasive knee replacement procedures involve laparoscopic techniques and robotic-assisted surgery technology. Many patients opt for minimally invasive knee arthroscopy because of its advantages over the alternatives. Though ideal for most knee and joint replacement situations, the procedure is not suitable for certain patients, such as those who are obese or have certain risk factors.
Robotic-assisted knee replacement surgery is performed by a highly skilled orthopedic surgeon who uses the surgical arms of the ROSA knee system to execute the procedure with better precision and accuracy than possible in alternative surgery types.
The ROSA knee system offers patients several distinct advantages to traditional and alternative knee and joint replacement and treatment options, including:
Minimally invasive and robotic-assisted knee replacement is best suited for patients who are:
- Do have not severe arthritis or osteoporosis
- Without severe limb or joint deformities or defects
Benefits of ROSA robotic-assisted knee replacement surgery include:
Lower treatment costs When considering knee replacement and alternative treatment options for joint pain, movement impairments, and stiffness, it helps to consider short- and long-term medical expenses. Robotic-assisted surgery enables patients to spend less time recovering so they can get back to work or leisure activities faster to minimize their medical costs.
Amber Chrischilles | November 18th, 2022
Experience Matters When It Comes To Selecting A Robotic Knee Replacement Surgeon
While technology helps to improve your outcomes after knee replacement surgery, it’s critical to have an experienced surgeon planning and guiding the procedure. MedStar Orthopaedic Institute is one of the largest orthopedic robotics programs in the country. In fact, we were the first in Maryland to use MAKO robotic technology for total knee replacements and we continue to perform more robotic-assisted joint replacements than any other hospital in the state.
When it comes to knee replacement, the right fit is critical for eliminating your pain and restoring your ability to participate in the activities you love. Our fellowship-trained orthopedic surgeons combine the highest level of expertise and experience with the latest advances in robotics and technology to ensure you don’t have to live with debilitating pain.
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Contemporary Tka Robotic Systems
|Awaiting product launch TKA release planned fall 2020|
Note. UKA, unicompartmental knee arthroplasty PFA, patellofemoral arthroplasty TKA, total knee arthroplasty THA, total hip arthroplasty CT, computed tomography NJ, New Jersey TN, Tennessee FL, Florida CA, California IN, Indiana XR, X-ray.