Precision Instrument

Hip new surgical technology gives Saint Francis Hospital-Memphis a knee up.



photograph courtesy St. Francis

MAKOplasty technology (MAKO) is making hip and
partial knee replacements a walk in the park for patients of Saint Francis Hospital-Memphis. MAKO technology uses a RIO robotic arm machine that enables surgeons to perform partial knee replacements with extreme precision and accuracy, and the tremendous results have shocked even seasoned medical professionals.

“I’ve been doing knee replacements for a long time, and I’ve never seen anything like that [machine],” says Dr. Apurva Dalal, orthopedic surgeon at Saint Francis Hospital and the only joint replacement surgeon in Memphis using this technology. “Everybody is skeptical [of new things], but truly for the patient this is the best thing I’ve ever seen because it’s so precise.”

Generally speaking, most people don’t want or need to think about knee replacement surgery until they’re at least 60, but there is a window between the ages of 40 and 60 in which active individuals often experience osteoarthritis, significant knee or joint pain.

In the past, most patients simply dealt with the pain until it was absolutely necessary to undergo total knee surgery later in life. MAKO technology makes the idea of partial knee surgery for this age group not only bearable but enticing. “It can recreate your own natural knee before it was diseased,” says Dalal. “The computer can look at a three-dimensional model of the knee and see what it would have looked like 40 years ago.”

He explains that not only is the robot extremely efficient and perfectly precise, it provides minimally invasive techniques that result in little to no recovery time for patients. He uses the example of his first MAKO patient, a 70-year-old woman who could barely walk with a walker. She had surgery on a Thursday, went home on Friday, and was walking around without a walker in Dalal’s office on Monday.

“Imagine how cool that surgery could be on somebody who’s 40 years old and fit and just suffering from some knee pain,” says Christine Fredric, senior vice president of business development at Saint Francis.  

Dalal has been performing surgeries since 1986 and underwent extensive training to become certified to operate the MAKO machine; Saint Francis is the only hospital in more than 200 miles that has access to this technology. While he is a firm believer in the technology, he admits that the learning curve was steep but worth it.

“Once you ‘play’ on the computer for 20 or 30 minutes and find ideally what the patient needs, then we lock in the MAKO, and the robot, controlled by me, goes and cuts the knee,”  says Dalal.

“The good thing is the robot will not make a mistake because even if you accidentally tell it to cut one millimeter differently [than what you programmed it for] it just quits working. It will only cut what you’ve told it to cut on the computer.”

From the patient’s perspective, the robot provides substantial comfort results since the measurements and angles are accurately taken before surgery. The best a human surgeon can do is what he or she can see with the naked eye, then wait for an x-ray post-surgery. The robot eliminates any guesswork and yields ideal outcomes again and again.

“The outcomes are good. The patients have done well, and I’m able to consistently reproduce results accurately, to a ‘T,’” says Dalal.

Currently the MAKO robot can only be utilized for partial knee replacements and hip replacements, but Dr. Dalal says the technology that would equip it for total knee replacement among other things is only two or three years away. “If you had a disease in which you qualified for this [procedure], this is the best thing going for you.”

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