INDIANAPOLIS — Total knee replacement surgery has been around since the late 1960s. Over time with arthroscopic surgery, improved materials and now robotic assisted systems, total knee replacement is considered one of the most successful procedures in all of medicine.
A group of orthopedic surgeons in Indianapolis has brought in what’s called the Stryker-Mako robotic arm assisted surgery system.
Dr. Joseph Maratt, an orthopedic surgeon with Forté Sports Medicine & Orthopedics, believes patients will be pleased.
“You end up with an implant that’s ideally placed for each patient,” said Dr. Maratt.
Knee replacement using this system starts with a CT scan of the joint.
“The CT scan creates a 3D model of the patient’s knee,” explained Dr. Maratt. “We preplan the surgery on that, refine the plan during the operation and then use a haptic guided saw so it’s a robotic arm that helps you control the saw.”
While the robotic system is in use it’s also collecting data.
“We’re good at collecting data from patients after the fact. There’s not been a great way to find out exactly what was done in the OR other than a surgeon dictating an operation note or entering something into a registry,” began Maratt. “But in this, every decision made can be measured by the robot and stored. So that once you have a big enough data set, you can go back and look at it and say, when we did this- the patient turned out like this.”
Implants have come a long way. Materials have improved to the point that wear and tear is not as great and revision surgery is rare. Knee replacements these days are expected to last the patient’s lifetime.
“It makes the rehab a little easier,” said Dr. Maratt. “When you use technology like this it makes it so that you can see without having to look into the joint itself. You have a 3D model, so you don’t have to pull the joint out of itself to see what you’re cutting.
It’s as if orthopedic surgeons, like Dr. Maratt, have a super assistant in the OR.
“The computers are going to guide the robotic arm to hold the saw in the correct plane,” said Dr. Maratt.
“But for a number of reasons it’s not going to move independently and cut anything. The surgeon has to push the saw forward, using the boundaries that are set up.”
Over 600,000 people undergo knee replacement surgery every year in the United States.