Orthopedic Surgery – Knee And Hip

Robotic Knee Surgery, Robotic Hip Surgery

MINIMALLY INVASIVE MUSCLE SPARING PATIENT SPECIFIC ROBOTIC TOTAL KNEE REPLACEMENT

An extremely arthritic or injured knee can become extremely painful during everyday activities and even at rest. Simple activities like stepping up or down stairs or walking can become excruciating. If you have failed conservative treatments such as physical therapy, visco-supplementation (i.e. Synvisc or Orthovisc injection), or steroid injection, then it may be time to consider Minimally Invasive Muscle Sparing Patient Specific Robotic Total Knee Replacement with Novocur.

A micro or minimally invasive total knee replacement is a surgical procedure in which the entire joint between the femur and the tibia is replaced with a prosthesis, usually composed of metal, polyethylene, or ceramics. The surgery is performed with the assistance of a robotic arm and is referred to as Makoplasty. The damaged cartilage is removed, and the end of the bones resurfaced and fitted with the prosthesis, while a plastic spacer allows the two parts of the prosthesis to move against each other easily and painlessly, much like the cartilage it replaced. This surgery is accomplished without having to cut any of the quadricep muscles, which is a leap in technology and greatly reduces recovery time. This type of total knee replacement can be expected to provide pain-free movement for between 25-30 years.

Minimally invasive patient specific robotic total knee replacement is a cutting edge treatment for patients requiring a total knee replacement. While there are many benefits to minimally invasive surgery, there can also be increased risk of complications if not done correctly. It is critical that you select a surgeon who is extremely experienced performing this operation. Dr. Brandon Gough is a talented and highly sought after orthopedic surgeon with a private orthopedics practice operating out of the Novocur facilities. Dr. Gough will work with you to understand the benefits and risk associated with this procedure. He will patiently answer all your questions and address any concerns you might have, and will work hand-in-hand with you to ensure that you are completely comfortable with your customized treatment plan and completely satisfied with the results.

Benefits of a Minimally Invasive Muscle Sparing Patient Specific Robotic Total Knee Replacement

A traditional total knee replacement is an invasive surgical procedure involving a long incision (10-12 inches) through the skin on top of the knee and incisions through the quadriceps tendon (which joins the large muscles of the thigh to the kneecap). A minimally invasive patient specific total knee replacement is a cutting edge procedure that represents a dramatic improvement over the more invasive, traditional approach:

  • It is minimally invasive: much smaller incisions, usually only 4-6 inches long. Moreover, Dr. Gough doesn’t cut into any of the muscles around the knee, resulting in less damage to the soft tissue, significantly less post-operative discomfort, and much faster return of complete knee function. This allows for faster initial recovery and return to activities sooner. Some of Dr. Gough’s patients return to golf in as little as 3 weeks after surgery.
  • It is patient specific: prior to surgery, Novocur will conduct a CT scan of the knee joint, using that model to customize the joint implant as well as instrumentation for each patient’s unique anatomy, and develop a surgical plan that is individually tailored to the specific needs of each patient. The pre-operative CT scan allows the surgeon to operate with greater accuracy, preserve more of the patient’s bone when preparing for implantation of the prosthesis, provide more accurate prosthetic alignment and positioning and results in a knee replacement that is superior in stablility, functionality and will last longer. One study indicates that implants placed with the robotic arm technology have a 0.4% failure rate two years after surgery, compared to 4% of implants placed manually.
  • Shorter and less painful recovery: reduced blood loss during and immediately after the surgery, shorter hospital stays, and less post-operative pain and discomfort. Because there is less damage to the soft tissue, patients generally experience a faster recovery and rehabilitation, regaining the full range of motion allowed by the prosthesis in a shorter time frame than allowed by a traditional total knee replacement. The rehabilitation following a total knee replacement was traditionally very difficult, but with the minimally invasive approach rehab seems like a much smaller mountain to climb.

    According to a randomized controlled trial, MAKOplasty patients experience less pain during the first week after surgery than do patients who underwent manual surgery after two months!

Procedure and Recovery

A minimally invasive patient specific total robotic knee replacement usually requires a procedural time of 1-1½ hours, followed by a short hospital stay; in fact, 95% of patients are able to leave the hospital within one day of surgery, while some are able to leave the same day. Most patients will have mild post-operative pain and discomfort, and will notice swelling around the joint immediately after the operation; these symptoms can usually be alleviated with Tylenol and Celebrex. Patients are encouraged to begin walking unassisted within hours of the procedure. With regular physical therapy, recovering full strength, energy, and range of motion can occur within a month or two of the procedure. During recovery, patients are advised to keep the knee in a comfortable position and wear comfortable, supportive shoes. Exercise every day is recommended, and patients can use icepacks regularly if they notice swelling or tenderness. During recovery, patients should avoid large bends, twisting movements, and high-impact activities like running and jumping.