Robotic-assisted surgery a new option for treating knee pain

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Dr. Kevin Jones

If you suffer from knee pain, you're in good company. More than 30 million Americans are afflicted with degenerative joint disease, often called "wear and tear" arthritis.

As we age, the cartilage cushioning our joints wears down, causing bone to rub on bone.

The odds of developing arthritis in your lifetime are virtually 100%. You might start experiencing symptoms in your 40s, but it's usually not until you reach your mid-60s that the pain becomes severe enough you turn to an orthopaedic specialist for relief.

Initially, your doctor will recommend conservative treatments like anti-inflammatory pain relievers or cortisone injections. When the pain begins to limit even simple activities, like climbing stairs or walking, it might be time for a total knee replacement.

With this procedure, also called total knee arthroplasty, the diseased joint is replaced with an artificial joint or implant designed to move much like a healthy human joint. Total knee replacement has been around for decades and has proven highly successful in alleviating pain and restoring function. Over the years, surgical techniques and implant design have continued to improve outcomes.

One of the most recent breakthroughs in total knee replacement is robotic-assisted surgery. Since the Mako Robotic Arm-Assisted Surgery System was introduced in 2006, more than 100,000 joint replacement procedures have been performed around the world.

It is important to understand the robot does not perform the surgery, make decisions on its own, or move without the surgeon guiding the robotic arm. However, the advanced technology enables a new level of accuracy for the alignment and placement of the artificial joint. The technology allows doctors to create a personalized pre-operative plan for the patient and implant the prosthetic knee components with greater precision, leading to better function and more natural movement.

Using a CT scan of your joint, the surgical system software generates a 3-D virtual model of your unique anatomy that the surgeon uses pre-operatively to determine the optimal size, orientation and alignment of the implant. In the operating room, the surgeon follows the plan, guiding the robotic instrument arm to remove only the diseased bone, preserving the healthy bone and ligaments around it.

A virtual boundary established by the robot prevents the surgeon from crossing the bone field, reducing irritation to the surrounding soft tissue. With less soft-tissue irritation, patients might experience diminished pain following surgery.

Once the arthritic bone and cartilage is removed, the surgeon uses the robotic instrument arm to position the new joint. The Mako System also allows the surgeon to make real-time adjustments to the plan during the surgery as needed.

The system also offers dynamic joint balancing. If the knee is well balanced, it will feel more natural and function better, which can extend the life of the implant. The technology also can be used for partial knee and total hip replacements.

Total knee replacement surgery typically involves a two-day hospital stay. Patients can return to daily activities three to six weeks following surgery.

Dr. Kevin Jones is a board-certified orthopaedic surgeon with Beaufort Memorial Orthopaedic Specialists in Bluffton and Beaufort.

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