In Aspen, surgeons embrace technology for more precise knee replacements

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OrthoAspen is the first facility on the Western Slope to offer Mako Robotic-Arm Assisted Technology

By Lauren Glendenning
Brought to you by OrthoAspen

The orthopedic surgeons at OrthoAspen are using a technology that not only improves the precision and accuracy of total knee replacement surgeries, it also results in less blood loss, better alignment, smaller incisions, less surgical time and a faster return of knee function.

Mako Robotic-Arm Assisted Technology is transforming the way joint replacement surgeries are being performed, according to Stryker, which manufactures the technology. Since 2006, more than 83,000 Mako hip and knee replacement surgeries have been performed around the world. OrthoAspen is the first facility on the Western Slope of Colorado to offer this type of partial and total knee replacement surgery, which it began offering in late 2012.

Dr. Tomas Pevny, an OrthoAspen surgeon and Mako specialist, said total knee replacement surgeries are expected to increase by 700 percent over the next 20 years.

“The first surgery is the best, meaning that if things fail and the knee has to be revised, the subsequent surgery is more difficult and results less satisfying,” Pevny said. “By using the robot, it allows us to get it right the first and most important time. Also, currently, the robot cannot be used for revision surgeries so the surgeon depends on the same subjective guidelines used in the past.”

How it works

Surgeons obtain a pre-operative CT scan of the knee, which provides the exact size and position of the replacement components. Prior to this technology, this was all done during surgery, using subjective techniques, Pevny said. A 3D model of the patient’s unique anatomy is generated and loaded into the Mako System software, which assists the surgeon in creating a personalized pre-operative plan.

“The Mako allows us to plan the sizing and alignment of the knee replacement off of a 3D CT scan. Real-time alterations to the plan can be made during surgery to correct the patient’s alignment and ensure that he/she has improved range of motion,” said OrthoAspen surgeon and Mako specialist Dr. Eleanor von Stade. “Once the plan is locked into the computer, the cuts made with the robot ensure perfect placement and alignment of the prosthesis.”

The Mako System also allows surgeons to make adjustments during surgery as needed. And while the robotic arm makes surgery more precise, it doesn’t actually perform surgeries.

“The surgeon is actively involved and manipulates the robot’s arm, which as a burr (for partial replacements) or saw (for total replacements) and cuts the bone based on pre-determined cuts calculated from the pre-opertaive plan (the 3D CT scan),” Pevny said. “The system has a protection function in that it is set up to shut down if the burr or saw deviates from the plan.”

Results

Because the saw will not activate unless it’s in the correct position, patients can enter the operating room with peace of mind. The result is a strong foundation for the knee components and less stress to the knee system over time, Pevny said.

“Osteoarthritis (OA) is very painful and limits one’s desire to remain active. The main indication for a Total Knee Replacement (TKR) is pain relief,” he said. “If left untreated, OA can lead to misalignment of the limb and deformity making TKR more technically difficult, results less predictable, and the recovery prolonged.”

By using this extremely reliable and reproducible technology, von Stade said surgeons using Mako technology can limit bone cuts and soft tissue dissection, which results in less trauma to the knee.