Orthopedic Surgeon Dr. Ronald Hillock Explains the MAKO Robot

I am frequently asked by patients and their families about “Laser Surgery” and “Robot Surgery” as if it is magic that can work miracles. Sadly this is not the case. So then what are the benefits of robotic surgery for partial knee replacement?

Let’s consider one of the biggest challenges with partial knee replacement; consistency. Joint replacement surgery is technically demanding and requires a highly-skilled surgeon. The implant must be aligned accurately and secured precisely or the patient’s function will be suboptimal.

The key to success in partial knee replacement, or in any surgery for that matter, is performing it repeatedly with reproducible results. The more accurate the plan, the more accurate the action which leads to more consistent outcomes. The robot allows me as a surgeon to perform precise, accurate bone shaping for optimal implant positioning and alignment. And the major benefit of using a robot for orthopedic surgery is that it helps the surgeon complete tasks repeatedly with more accuracy.

The robot is a high tech tool, but like any other knife or retractor, it is just another instrument to aid the in the delivery of treatment. And the decision to go ahead with knee replacement surgery, the actual surgical procedure and the patient’s recovery are all primarily based on the skill and judgment of the surgeon.

Let’s take a step back and consider what are the advantages of a partial knee replacement. We divide the knee into three compartments, they are: the patellofemoral or kneecap compartment, the medial or inside compartment and the lateral or outside compartment. If arthritic changes or cartilage damage is limited to a single compartment of the knee, then ideally it would be best to replace only that one area. The normal areas of the joint are retained and function is then closer to a normal knee. The ligaments are left in their natural position and the knee motion feels more natural once the patient has recovered.

MAKOplasty Robotic Arm – Orthopedic Surgeon – Dr. Ronald Hillock – VoyagerMed

One of the other major challenges with partial knee replacement is the method by which the bone has been cut and contoured during traditional surgery. The surgeon must take great care to align the implants in a manner that allows for smooth gliding motion. If the implants are not aligned properly then they will wear too soon. Early wear leads to early failure. Historically the best longevity that could be expected from a partial knee replacement, or uni-knee replacement, was about 5 to 7 years of smooth pain free function.

Robotic surgery has now arrived in Las Vegas for Joint Replacement. The MAKO robot allows us to more accurately and consistently perform complex reconstructions. The MAKO Robot is not an android like R2D2, but rather a robotic arm with a precise cutting tool attached. Complex planning goes into the process that leads to each surgery with the MAKO system. The MAKO robot only cuts what the surgeon wishes to be cut, nothing more or less.


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