Author: Leslie Toldo
If you need a hip or knee replacement, you have plenty of company. Surgeons replace nearly half a million hips and 800 thousand knees every year.
“A joint replacement is simply a resurfacing of the boney ends of a joint with metal and plastic,” said McLaren Flint orthopedic surgeon Dr. Seann Willson. “The bone ends are contoured to accept the implants, which are then glued or pressed into the bone.”
During a traditional knee replacement or arthroplasty, surgeons use a jig placed in a hole drilled down through the bone canal to contour the ends of the bone to fit the implants. But the robotic arm assisted system, called Mako, is making it possible to get the job done with even more personalized precision.
“We get a CT scan before surgery that gives us a three-dimensional model of the knee or hip from which we can plan the implant size and placement for each individual patient,” Dr. Willson explains. “The Mako robotically assists with contouring the bone and placement of implants as planned on that model.
“Not having to open up the bone can lead to less blood loss and swelling, and less pain,” And being able to plan and place the knee with a 3D plan puts the knee as close as possible to the ideal position, meaning the patient has maximal range of motion.”
The benefits are the same for Mako assisted hip replacements, and the surgeon can use that 3D model to determine whether there are any boney blocks that can put the patient at risk of forcing the new hip out of the socket.
“With the model, we know this ahead of time and can adjust as needed to decrease that risk,” said Dr. Willson. “Also, the robot minimizes the difference in leg length after surgery.”
Mako is not only very effective for crooked or bent legs, but also especially beneficial for patients who have implants from previous surgeries, like an ACL reconstruction.
“The 3D model will indicate if they need to be removed or if we can work around them,” Dr. Willson said. “For hip replacements, the 3D plan will also tell us if there will be issues due to implants or significant bone loss.”
Joint replacements were typically designed with older patients in mind, but it is not uncommon for younger patients to need the procedures.
“These are mechanical devices, with finite time before failure,” Dr. Willson said. “In all patients, but especially younger patients, we want to try everything else before surgery. This includes optimizing body weight, exercises, physical therapy, non-opioid medications, injections, and modifying activities. “
The trick is getting in to a doctor when you start to experience symptoms:
- Pain that prevents you from sleeping or doing normal activities.
- Pain or stiffness, even when resting.
- Difficulty moving
- Swelling or inflammation
- Limping
- Grating or rubbing sounds when you move your joint.
“It is rare for someone to wait to long, but if you put off getting help it can affect your postoperative range of motion and function in extreme cases,” said Dr. Willson.
Learn more about orthopedic services at McLaren Flint, including the Mako technology here.