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Robotic Total Joint Replacement!!

10/12/2017

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Stryker Mako robotic arm will be used for total knee and total hip replacement
Stryker Mako Robotic Arm will improve joint replacement outcomes.
The future is here!

We are thrilled to announce that we are establishing a robotically assisted total joint replacement program here in Hudson, New York. We will be using the  Stryker Mako system for partial knee replacements, total knee replacements, and total hip replacements. 

What is the big deal?

Accuracy.


Patients and surgeons are very fortunate in that total joint replacement is reproducible, predictable and forgiving. That does not mean it is perfect. 

While patients routinely report dramatic pain relief once rehabilitated, we as surgeons are thrilled when they report that their new joint feels "normal." This occurs less often than anyone would like. 

During surgery, we use alignment guides designed to produce certain angles, or remove a particular amount of bone. These guides have been the same for decades. Good surgeons will achieve consistent results, but even the very best surgeons will admit that there is more variability than anyone would like. This can occur for a variety of reasons, but it is impossible to completely avoid. 

Using a robotic arm during surgery, we can implant joint prostheses within a millimeter and a degree of the intended plan. Every time. No surgeon, anywhere, can do this using manual tools. 

Before you begin imagining a robotic arm like those seen in vehicle assembly, let me explain how the Styker Mako robotic arm works. Preoperatively, the patient undergoes a CT scan. The surgeon then plans the surgery virtually on the computer, determining the intended alignment and position of the prosthesis. In the operating room, the surgeon makes the surgical approach and then uses a probe to orient the robotic software to the position of the patients bones. During preparation of the bone, the robotic arm prevents anything but the exact plan from being executed. It does this passively. At no point can the robot move itself. The surgeon positions the tools and prostheses and once perfectly aligned, the robot locks the tool into this perfect position. The handpiece, which is operated by the surgeon, will not be activated until it is perfectly aligned and in a safe position. The surgeon then activates the tool, or manually impacts the prosthesis depending on the step in the procedure. The surgeon gets real-time information regarding implant position as it is happening. 

From the surgeon's perspective, this information is invaluable! We can adjust our plan intraoperatively if needed. We can execute our plan perfectly, every time. During knee replacement, we can balance ligaments degree by degree. During hip replacement, we can optimize acetabular (socket) placement, leg length, and offset.

When dealing with complex biological systems, there will always be factors beyond our control. Robotic total joint replacement is an amazing tool, which gives us tighter control over prosthetic implantation and soft tissue balance. This  will improve the function and longevity of implants for patients. 

Much of this website is directed toward proper rehabilitation after joint replacement. While prosthetic alignment and soft tissue balance will be improved using the Mako robot, appropriate rehabilitation will always be crucial to maximizing outcomes. 

1 Comment

    Dr. Gorczynski

    Orthopedic Surgeon focused on the entire patient, not just a single joint.

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