How Robotics Are Making Joint Replacements Better Than Ever Before

As surgeons, our job is not just to take care of you, but to make sure that we constantly stay on the cusp of technology in our field so that we can offer the latest and most effective options for our patients. We always want to ensure we are using systems that allow for reproducibility, meaning outcomes will be consistently excellent.

OrthoCarolina Scotland (Laurinburg, NC) is one of the first groups in the Carolinas to offer partial knee resurfacing and total hip replacement procedures using robotic technology. This surgeon-controlled MAKO robotic arm system enables accurate alignment and placement of implants. From a preoperative CT scan, an accurate 3D computerized model of the diseased joint is generated, allowing planning for the optimal final position of the implants. The robot arm controlled by the surgeon is then used to accurately shape the bone and place the implant exactly as planned. Robotic-arm assisted surgery is a new approach to joint replacement that provides a higher level of precision and reproducibility of implant alignment and positioning, which allows improved range of motion, stability and function.

We perform our robotic system surgeries at Scotland Health Care System. Here is what each entails:

Robotically-assisted partial knee resurfacing

This treatment option is for adults suffering from early to mid-stage osteoarthritis that has not yet progressed to all three compartments of the knee. It is less invasive than total knee surgery. A pre-surgical plan is created based on a CT scan of the patient’s knee, and we then use the robotic arm during surgery to precisely execute that plan, resurfacing the diseased portion of the knee, while sparing healthy bone and ligaments for a more natural feeling knee. The implants are selected and secured to restore proper stability based on real-time data about tension in knee ligaments through the range of motion, allowing the knee to move smoothly again.

Compared to traditional total knee replacement surgery, the robotic-arm assisted partial knee procedure is a soft tissue and bone sparing procedure with smaller incisions, less scarring, shorter hospitalization and faster recovery.

Robotically-assisted total hip replacement

As in robotic knee replacement procedures, final implant position is first planned on a 3D image obtained from CT of the individual patient’s hip joint. This surgery provides visualization of the joint and bio-mechanical data to guide the bone preparation and implant positioning to match the pre-surgical plan. After measuring precisely any limb length difference, and preparing the femur or thighbone, we use the robotic arm to accurately ream and shape the acetabulum (socket) on the pelvic side the hip joint, and then to implant the prosthetic cup to the pre-planned correct depth and orientation.

The robotic system guides the final position of total hip implants to achieve precise and optimal restoration of limb length, joint mobility and stability, reducing the likelihood of dislocation versus manual total hip replacement.

Ralph E. Carter, III, MD is a hip and knee surgeon with OrthoCarolina Scotland in Laurinburg, NC.