For patients, wider adoption of robot-assisted joint replacement from companies like Mako may mean more accurate surgery and faster recovery times.
Demand for joint replacements in the United States is on the rise, with total knee replacements expected to increase by 673 percent by 2030, and total hip replacements by 174 percent. With studies showing that up to 30 percent of today’s patients are unsatisfied after traditional joint replacement surgery, there is a clear opportunity for robotics to step in and revolutionize orthopedics.
Medical technology company Stryker acquired the joint-replacement robot producer Mako for nearly $1.65 billion in 2013, confident that robotics would have a key part to play in the future of knee and hip surgery. The Mako system offers partial and total knee replacement and total hip applications.
Littleton Adventist Hospital in Denver is the latest practise to put its faith in the robot-assisted surgery. With Mako reportedly costing upwards of $1 million dollars, it’s a huge investment at a time when many practises are looking to reduce their orthopaedic costs.
However, the robotic-arm can drastically enhance knee and hip operations, increasing their success rate and decreasing recovery times – meaning long-term costs should help offset the initial outlay.
How robot-assisted joint replacement works
“The Mako robotic-arm allows us to provide each patient with a personalized surgical experience that’s specifically tailored to their needs and anatomy,” said Dr Robert Thomas, who performs joint replacements at Littleton Adventist. “Using a virtual 3D model, the Mako system allows surgeons to design each patient’s surgical plan prior to surgery for more precise implant placement.”
Partial knee replacements (PKR) are designed to relieve the pain caused by osteoarthritis (OA). By targeting the part of your knee damaged by OA, a surgeon can replace the diseased bone while helping to spare the healthy areas and ligaments surrounding it.
Mako technology can enhance this process by providing a CT-derived, patient-specific 3D model to pre-plan the partial knee replacement. This enables accurate planning of implant size and alignment.
During an operation, the surgeon guides the Mako robotic-arm, which will limit the their movements, as they prepare the bone for the implant, to within the boundaries set by the pre-plan. This means only the diseased bone is removed. The robot will then help with positioning the implant based on the patient’s anatomy.
“We’re proud to be the first facility in our area to offer this advanced robotic technology,” said Michael Brendel, chief operating officer at Littleton Adventist. “This demonstrates our commitment to precision medicine and expands our regional leadership in robotic surgery.”
The argument for robotics in surgery
As with all new drugs and medical equipment, extensive testing and clinical evidence is necessary to prove an invention’s safety and value. Stryker is partnering with surgeons and user experience experts to study the operating room workflow and learning curve of robot-assisted joint replacement.
Over 50 published, peer-reviewed clinical publications have backed the technology, as well as around 350 scientific abstracts accepted at peer reviewed scientific conferences. The robot has also proved itself since launch, with over 100,000 procedures performed to date.
The stability and precision of robotics means that the notoriously difficult task of knee resurfacing is made much easier. By limiting the unnecessary removal of healthy tissue and bone, and better positioning implants, trauma and pain is reduced.
In an interview with MedCityNews Stuart Simpson, vice president and general manager at Stryker revealed, “We have seen the 30-day complication rate reduced by 36 percent with Mako versus non-Mako. And we have seen the cost of complications and readmissions for Mako cases 66% lower than non-Mako cases in the 90-day period,” he said. “And that’s even accounting for the additional cost of using Mako.”