Robotic Assistance for Joint Replacement

By Ali Dalal, MD

Robotically assisted total joint replacement through MAKOPlasty™ is available for total hip replacement, partial knee replacement, and will soon expand its capabilities to total knee replacement. This short article is meant to explain how the technology works, why it is valuable to both surgeon and patient, and how it is different from other forms of computer assisted surgery. I was trained in robotically assisted joint replacement surgery during my fellowship with Kenneth Gustke, MD, one of the pioneers of this technology, and have seen firsthand some of its benefits.

Like all surgery, robotically assisted surgery starts with a plan. The surgery is planned on a CT scan which provides the surgeon a three-dimensional look provided by conventional x-rays. The 3D reconstruction allows your surgeon to accurately plan your surgery before ever stepping foot into the operating room. It gives very precise measurements with respect to the size and alignment of each component that is to be placed.

What really sets the technology apart is the RIO™ robotic arm. The robotic arm in surgery is not fully automated like one may see on an assembly line, but is “driven” by the surgeon. The surgical plan from the CT scan is downloaded onto the robot. The robot, which is linked to a computer in the operating room then provides the surgeon with visual and haptic feedback and will not allow any errors or deviations from the plan, providing a failsafe mechanism. Unlike computer navigated surgery which provides a road map of the surgery without a vehicle to get your to your destination, MAKOPlasty offers the roadmap, in-dash GPS, and every kind of safety warning imaginable to get you to the end  result without any detours. The improvement in implant placement has been validated in orthopaedic literature as well.

Considering how common joint replacement has become, patients expect a functional and reproducible result that will last for decades. Decreasing variations in implant placement through the use of latest technology just may help surgeons and patients realize their shared goal.