New for the Knee: MAKOplasty for Osteoarthritis

May 16, 2012
Filed under Health & Wellness

By Drs. Marc Hungerford and Kamala Littleton

The Orthopedic Specialty Hospital at Mercy Medical Center

Osteoarthritis (OA) is the most common form of arthritis and leading cause of disability worldwide. OA is a degenerative joint disease characterized by the breakdown and eventual loss of joint cartilage, the cushion between bones of a joint. Patients with OA have had the top layer of cartilage break down and wear away, causing bones under the cartilage to rub together, causing pain.

Symptoms of knee osteoarthritis include pain while standing or walking short distances, climbing up or down stairs, getting in and out of chairs, swelling, a grating sensation or crunching feeling in the knee during use, joint stiffness, etc.

Total knee arthroplasty (TKA) or replacement remains the ‘gold standard’ for treating degenerative joint disease. While proven to be a very successful procedure, it’s an invasive procedure and requires extensive rehabilitation. It is also best suited for patients with late stage osteoarthritis—that is, where all three compartments of the knee are affected.

Fortunately, there is now a new option available for patients with this disease–MAKOplasty Partial Knee Resurfacing using the RIO Robotic Arm Interactive Orthopedic System.

MAKOplasty involves replacing the worn, damaged and missing cartilage with an implant made out of metal and plastic. It’s not unlike capping a tooth. The basic structure of the knee remains — most of the bone, the ligaments, the skin, the nerves, the muscles — as the damaged and diseased part of the knee is removed and a new bearing surface is put in place. .

Key to this procedure is the RIO Robotic Arm Interactive Orthopedic System. During surgery, the RIO provides the surgeon with real-time visual, tactile and auditory feedback which optimizes joint resurfacing and implant positioning—it’s a kind of “GPS” for the knee. It helps the surgeon place the implant which is crucial to achieving natural knee motion for the patient after surgery.

Using this information, the RIO robot resurfaces the diseased area of the knee and replaces it with the implant. This approach provides a less invasive option for patients who are living with the daily pain of early to mid-stage knee osteoarthritis.

Benefits of the MAKOplasty Partial Knee Resurfacing include:

· Joint resurfacing
· Bone sparing
· Smaller incision
· Less scarring
· Reduced blood loss
· Minimal hospitalization
· Rapid recovery

Proper implant alignment and precise positioning during surgery, as afforded by the RIO Robotic Arm Interactive Orthopedic System, can improve the life expectancy of an implant. The longer an implant lasts, the less likely the need for another surgery to replace it.

The use of RIO helps ensure the knee implant is properly aligned and positioned to ensure long implant life. In addition, because very little bone is actually removed during this procedure, the implants can be easily replaced should another procedure, like a total knee replacement, eventually be necessary.

In traditional knee replacement surgery, at least the Anterior Cruciate Ligament and frequently the Posterior Cruciate ligaments are cut and the entire joint surface is removed and replaced with an artificial implant. TKA performed in patients with early stage osteoarthritis typically involves removing healthy cartilage. A recent Duke University study revealed that over 90 percent of men and women would decline having total knee surgery.

On average about 600,000 patients undergo TKA, though there are about 15 million people who suffer from knee osteoarthritis. For patients who undergo TKA, a return to normal life activities may range between one and six months. The average short-term recovery time for a total knee replacement is between 6 and 12 weeks.

In MAKOplasty cases, hospital stays average from one to three days. In many cases, patients are walking soon after surgery, driving a car within a few weeks and returning to their normal activities shortly thereafter. MAKOplasty provides surgeons with another option for patients who are reticent about TKA.

With the RIO Robotic Arm, we marry the tools with the technique to achieve the best possible result for patients suffering with early to mid-stage knee OA. We resurface the diseased portion of the knee, sparing the patient’s healthy bone and surrounding tissue. An implant is then secured to the joint so the knee can move smoothly again.

Mercy Medical Center (www.mdmercy.com) in Baltimore is the first hospital in Maryland to offer robotic assisted partial knee resurfacing. With over 80 cases since last summer, we are very pleased with the results to date.

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