Several months ago, Maury Regional Medical Center introduced their new Mako robotic surgical device to assist with a variety of surgical orthopedic procedures. Dr. Scott McCall and Dr. Cason Shirley are utilizing this machine to perform total knee replacements, partial knee replacements, and total hip replacements. This emergent technology is able to assist surgeons and ensure increased accuracy with the placement of surgical components. Maury Regional has been performing Mako surgeries since October of 2017. They estimate they have performed over 100 since then, and more are scheduled every day.
There are a variety of joint problems that can ultimately lead to surgery. A key reason is arthritis which can present with pain, stiffness and inflammation in the joints. For those over 60, osteoarthritis is typically the most common form. The progressive wear and tear on joints and cartilage leads to limited range of motion, significant pain deep within the joint, or occasionally the feeling of your bones catching or grating against each other. A knee or hip replacement typically relieves the pain and discomfort associated with this degenerative condition. Joint replacements can also be used to treat pain related to a previous trauma or injury to the joint.
Often before proceeding with joint replacement there may be several weeks of physical therapy to determine if this may improve your joint pain and function. If given the opportunity to stretch, strengthen, and increase flexibility, pain may decrease and function may improve to the point where the patient may be able to delay surgery. Stronger muscles and improved flexibility can help stabilize the joint and reduce stress on an arthritic knee or hip. Other conservative treatment options include oral anti-inflammatory medicines or injections of cortisone or a lubricant type material into the knee.
For those patients who find themselves a candidate for a Mako joint replacement surgery, there may be some questions about how the surgery is performed and how it varies from a traditional surgery.
“With Mako, we can provide each patient with a personalized surgical experience based on their specific diagnosis and anatomy,” said Dr. Scott McCall. “Using a virtual 3D model, Mako allows surgeons to create each patient’s surgical plan pre-operatively before entering the operating room.”
One misconception is that the robot itself controls the incisions and that the doctor has very little input, which isn’t the case. “The procedure is not radically different than what we’ve done before,” Dr. Scott McCall said. “The surgeon is not sitting in a back room with joysticks doing surgery outside of the operating room. The robot sets the plan specific to the patient, and you can make small variations to maximize ligament replacement. The surgeon has control over the robot and the surgery at all times; however, the robot can make cuts a human cannot do.”
These patient-specific plans consider many factors, including gender, exact shape and measurements of the patient’s joint, and how the joint moves. These plans assist the surgeon in performing the surgery and ensure the most accurate delivery of the surgical design.
To prep for the surgery, the bone that will be fitted for the implant must first be sculpted, or resurfaced, to remove any diseased bone and cartilage. The new clean surface is then ready for the implant. Your doctor will discuss with you the different options of implants based on your lifestyle and individual needs.
“During surgery, we can validate that plan and make any other necessary adjustments to tailor it precisely to what the patient needs,” said Dr. Cason Shirley. “It’s exciting to be able to offer this transformative technology across the joint replacement service line to perform total knee, total hip and partial knee replacements.”
It has also been shown that patients who undergo a Mako-assisted surgery may see benefits such as a smaller incision, less pain, and a faster recovery. Every patient responds differently to surgery and you may not experience all of these benefits. Rehabilitation after a Mako surgery is not any different from a traditional surgery, with approximately six to eight weeks of physical therapy required to strengthen the joint and regain motion.
“This is a multi-million dollar investment by Maury Regional Medical Center which allows us to offer cutting-edge technology to our patients and improve patient outcomes,” said McCall.