By JON CORNELIUS, MD

Is knee pain keeping your patients … or you … from living life to the fullest? Are you no longer doing things that you want to be doing? Are you no longer resting well at night?  If the answer to these questions is yes, then the issue may be a result of degenerative change of the knee, or osteoarthritis. The good news for patients suffering from osteoarthritis of the knee is that we live in exciting times.

Many great advances have occurred in knee replacement surgery. Recent improvements in surgical technique, rehabilitation programs, medication management, and anesthesia options have all contributed to great gains for knee replacement patients. Patients are having less pain and quicker recoveries than ever before. The latest improvement for knee replacement patients is robotic assisted total knee replacement.

As one of the first surgeons in the state to use the MAKOplasty Robotic Joint Replacement system, I initially started performing robotic assisted partial knee replacements in 2011 and saw the great improvements in recovery that were possible for partial knee replacement patients. The speed of recovery was shocking to me after having done traditional partial and total knee replacement surgery.

The problem, however, is that most knee replacement patients require a total knee rather than partial. Now that the robotic assisted total knee replacement is here, I think we will see it revolutionize how patients want their knee surgery performed.

Using a computer-generated model of the knee based on a CT scan of the patient’s knee, we can accurately place the total knee replacement implants to match the exact needs of the patient’s anatomy. We get real time information during the surgery to assure the replacement will match the patient. Using this technology, we can make sure that knee replacement parts are put in accurately, with reproducibility, while matching the patient’s unique anatomy.

A properly installed knee replacement will last longer than a knee that is placed just out of proper alignment, and this system ensures the proper placement. When the implant is placed to match the unique anatomy of the patient, the result is a more natural feeling knee. Using the robotic assisted surgery technique, we have great confidence in the position of the implants, and this allows for smaller incisions and less irritation to adjacent tissues, which will lead to an even quicker recovery than we have seen previously. Also, smaller incisions lead to less blood loss and less scarring.

Patients should know that the robotic assisted knee replacement surgery does not result in the robot actively doing anything during the surgery. It does not make any surgical decisions or do anything to the patient. It is a passive instrument that is run by the surgeon at all times. I like to think of it as an intelligent tool that makes the surgery easier on the patient.

When demonstrating the software and robotic equipment to a patient recently, she jokingly remarked, “It looks like a monkey could do it!” While I do not see a future of surgery without surgeons, it certainly makes the knee replacement safer for the patient and affords them a quicker recovery.

Using the software to make the surgical decisions is the difficult part, but performing the shaping of the bone using the robotic arm is quite safe as it provides boundaries to prevent injury to adjacent tissues.

In addition to the other advances listed above, the robotic assisted total knee replacement system allows for patients to have a customized approach to their knee replacement surgery and leads to a faster return to life as it was meant to be lived. For most patients, knee replacement surgery is now an overnight stay in the hospital before being discharged to home. The biggest news is knee replacement does not have to be intimidating or something to be feared.

To see if your patients … or you, yourself … might be a candidate for robotic assisted total knee replacement, feel free to reach out to me at my office 615-547-6700.

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Jonathon P. Cornelius, MD, is a board certified orthopaedic surgeon with Hughston Clinic Orthopaedics. He specializes in sports medicine disorders, orthopaedic trauma, minimally invasive joint replacements and MAKOplasty Robotic Joint Replacement. For more information go online to hughston.com/hughston-clinic-tennessee.