The Mako robot, a specialized assistant for orthopedic surgeons, is changing the game in knee and hip replacements. Precise and customized, it results in reduced pain, shorter hospital stays, and less physical therapy for patients.
Arthritis is more common than we think. According to the CDC, by 2040, a fourth of the U.S. population is projected to have doctor-diagnosed arthritis as the risk increases with age. Osteoarthritis is the most common form of this disease and some of the most frequent procedures are knee and hip replacements.
Doctors at Baptist Health’s Miami Orthopedics & Sports Medicine Institute have a new helper that makes these procedures a lot easier and more precise. It’s the Mako, a specialized robot that assists doctors in planning and performing surgeries. What makes this robot a pretty amazing assistant for orthopedic surgeons? I visited the Institute, which is the first facility in Miami-Dade County to acquire the Mako Robotic-Arm surgery assisting robot and I was impressed by what I saw.
Robotic-assisted surgery is not new and it’s getting more and more specialized. In the case of the Mako robot, it specializes in total or partial knee or hip replacements, which means that it has been specifically designed just for these types of procedures. It allows doctors to use the Mako software to pre-plan the surgery and perform the procedure, with the assistance of the robotic arm precisely removing the bone and cartilage needed for the knee or hip replacement.
First, the patient undergoes a CT scan which creates an image in 3D of the area that needs to be operated on. As you know, each diagnosis is unique, and the surgery needs to be precisely customized for each patient, so the specific anatomical information from the scan is added to the Mako robot platform to help plan the surgery and assist during the procedure.
Why a CT scan and not a regular X-ray? CT stands for computerized tomography and provides more detailed images than traditional X-rays, as they can show more details such as soft tissue, blood vessels and even a 3D image of the bones that are going to be operated on. This information allows the doctors and technicians to calibrate the Mako robot for the procedure that needs to be performed, creating a plan that allows them to know exactly where to place the implant so the joint is balanced.
With the plan in place, the robot is calibrated, the patient is placed on the operating table and the surgery can begin. Since the placement between the robot and the patient is so precise, there is no guessing on the positioning and motion of the robotic arm when it’s time for it to get to work.
The surgeon is watching a live image of the procedure on a screen while using the robot to make the incisions. One of the cool features of using this technology is that since the robot has been programmed precisely for the cuts that need to be made, it also creates a virtual wall where the cuts must be stopped. This allows the surgeon to make precise cuts and it even has a haptic feedback mechanism and sound alerts that notifies the surgeon when the planned cutting depth has been reached. As an added safety mechanism, the robot completely locks the arm and cuts power to the cutting tool to prevent a deeper cut than planned. This helps preserve healthy bone and surrounding soft tissues.
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After the robotic-assisted surgical incisions are done, the implant is placed, and the recovery period begins. Over 300,000 procedures using this technology have been performed worldwide. Studies have shown that surgeries such as knee replacements performed with the assistance of this robot result in reduced pain, less time in the hospital, and reduced need for physical therapy. This technology is definitely a win for patients and I’m sure doctors are pretty happy with those results as well.