New Robot Brings Unprecedented Personalization and Accuracy to Orthopedic Surgery in BrookingsJun 21, 2018 06:00AM ● By MED Magazine
By Alex Strauss
Earlier this spring, Brookings Health System became the second facility in South Dakota to offer robotic-arm assisted total knee, partial knee and total hip replacements with Stryker’s Mako System. By adding the system, they got more than just an advanced new piece of equipment—they also got an enthusiastic new surgeon.
“I initially saw this tool in March 2016 at a conference and was blown away,” says orthopedic surgeon Dr. Mark Mayer, who recently relocated to Brookings from Michigan. Before the move, Mayer was routinely driving long distances to use the robot on his patients in Michigan. “When I talked to the hospital here in Brookings, I said if you are willing to buy this robot, I’ll come out there. To have access to this technology any time is fantastic.”
The Mako system negates the need for manual templates and cutting blocks, allowing for a truly personalized approach to surgery based on each patient’s diagnosis and anatomy. The system uses CT-based 3D modeling to create a comprehensive preoperative surgical plan—including implant size, orientation, and alignment—which can then be validated and even fine-tuned in the operating room.
“For me, it’s very personal,” says Dr. Mayer. “I want the best outcome for every patient, every time. Now, we can take a patient whose knee doesn’t straighten the last 8 degrees and I can do the case and see that they are better but they still can’t straighten the last 4 degrees. And I can say, let’s take another ½ mm off the end of the femur and then reassess. You can make that decision during surgery.”
The Mako system also allows Mayer to make subtle adjustments to the positioning of implants intraoperatively, something that is much more difficult to do with manual systems.
“With chronic degenerative problems, ligaments can be tight,” says Dr Mayer. “We use preoperative planning to decide on a good starting point for positioning. Then we go in there and get objective data and reassess, tilt the component a little bit, release tendons or ligaments if we have to, etc.”
“We are looking to not only start with good tires and to put them on, but to also ensure that they are well-balanced.”
By allowing the surgeon to establish a virtual “boundary” around the cutting field, the Mako system not only reduces the risk of cutting errors, but also requires less retraction of the tissues for reduced postoperative pain and faster recovery.
“It’s amazing for a town this size to have access to this technology. There is nothing on the market even close to being comparable,” says Dr. Mayer.
The demand for total knee replacements in the United States are estimated to increase by 673 percent by 2030, while primary total hip replacements are expected to increase by 174 percent.