Robotic Assisted Total Knee Replacement

MAKO Robotic Knee Replacement Surgery

Osteoarthritis of the Knee can make everyday activities difficult to perform, and if non-surgical treatments are tried and aren’t effective, surgery may be your best option to relieve pain and stiffness and get you back to your daily activities. Knee replacement surgery is more precise and effective than ever before, with a newer technology, Mako robotic-assisted knee replacement.

What is Mako Robotic Assisted surgery?

Mako robotic assisted surgery is a technology developed for knee replacement surgeries. It allows Dr Thomas to pre-plan your surgery using Mako’s software and then perform the operation by guiding the robotic arm to precisely remove bone and cartilage, balance the knee, minimise soft tissue releases and place the implant in the planned optimal position. The Measure Twice and Cut Once philosophy.

Why is Robotic Assisted surgeryused?

This technology allows your surgeon to use a CT scan, which is 3D, as opposed to plain X-ray which is 2D, to create a 3D virtual model of your knee’s unique anatomy. The uniquely detailed and personalized view enables Dr Thomas to create a surgery plan that can be adjusted if necessary, during the surgery to give you the best possible outcome.

In addition, when preparing the bone for the implant, the robotic arm guides Dr Thomas within the predefined area and alignment during bone cuts, allowing for a more accurate and better-aligned knee replacement.

What does the procedure involve?

Using the CT scan and the Mako program, a 3D virtual model of your knee. Dr Thomas will then place the implant on the virtual knee model, and once the appropriate position has been chosen, this plan can be implemented during surgery.

As you’re under general anaesthesia, Dr Thomas places the Robotic array tools on the femur (thigh bone) and tibia (leg bone). He then assesses your knee movement and the tension of the ligaments on the either side of the knee. This data collected is used in conjunction with the preoperative plan to make the final plan for bone cuts, ligament balance and implant placement. Mako’s robot arm, along with Dr Thomas, will hold the surgical instrument. Dr Thomas 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 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 that’s been affected by arthritis. The implant is placed, the joint is properly balanced, and if necessary, Dr Thomas can make adjustments.

What is recovery like?

Recovery is usually quicker than it is with traditional knee replacement methods. You’ll be able to walk just hours after your surgery, and you’ll probably be able to return to your everyday activities in around 4-6 weeks. The exact amount of time is different for every patient, depending on your health and the extent of your surgery.

Pros of Robotic Assisted Surgery

Mako joint replacement technology has been increasingly popular and has been widely welcomed by both patients and surgeons alike and has many benefits:

• It allows surgeons to create a personalised surgical plan so they can position the implants with absolute accuracy.
• The standard replacement joint prosthesis is individually optimised to match the patient’s anatomy for greater freedom from pain from any mismatch.
• Intraoperatively,the system maps your natural joint movement patterns, helping to minimise excessive stress on the soft tissues and ligaments. This should ensure that you will be able to move in a natural way once the implant is in place.
• There appear to be fewer prosthesis complications after surgery.
• Rehabilitation times tend to be shorter.
• Reduced Revision Surgery, there is less chance of implant failure with possibly less need for revision surgery.
• Safety is improved. With the Mako system turned on, surgeons can only perform within their pre-operative plans due to the robot restricting cutting outside of the pre-planned area. This reduces the risk of human error.
• There is a possibility that blood loss may be reduced as there is less unnecessary exposed bone surface left to bleed.

Cons of Robotic Assisted Surgery

As with any type of procedure, Mako is not without its drawbacks.

• Surgical time is likely to be slightly longer than with traditional joint replacements,potentially exposing patients to theoretically greater risk of infection.
• Any computerised system is only as good as the information that is input into it. This includes the quality of the initial CT scans, and the proficiency of the team using the Mako system. Appropriate training and experience help the workflow process and optimally the final surgical result achieved.
• This is a new technology for joint replacement implantation and, as such, there is only early evidence to show long-term enhanced implant performance. However, the actual implants used are already traditionally tried and tested prostheses.(Dr Thomas uses the Stryker Triathlon)

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