We’re active all of our lives, using our knees and hips to do things with ease, never thinking that pain could prevent us from doing something as simple as walking. But knee and hip pain are two of the most common complaints we get from our orthopedic patients. In fact, 50 million people in the United States suffer with knee pain and 1 in 3 adults deal with hip pain that interfere with their daily lives.
In most cases, the pain is due to osteoarthritis, a common condition in which the cartilage between the joints wears away. Unfortunately, without knee replacement or hip replacement surgery, the pain will worsen as the cartilage continues to wear away. Thankfully, there is hope. At Kelsey-Seybold Clinic, my colleague Catherine Cahill, M.D., and I are proud to offer Mako® physician-controlled robotic surgery for knee and hip replacement.
Total Knee Replacement Surgery
There is an enormous amount of pressure on the knee joint. As much as we walk, jump, run, exercise, and bend our knees, this half-inch joint absorbs up to eight times our body weight. And, typically, as we age, we gain weight and our joints become weaker. This creates a recipe for chronic pain.
While not everyone is a candidate for knee replacement, in most cases of osteoarthritis, medication, injections, activity modification, or braces alone will not alleviate pain and stiffness enough to allow continuation of daily activities. However, if cartilage on more than one part of the knee joint is damaged, we may recommend a total knee replacement using Mako robotic-arm assisted technology.
Our orthopedic team at Kelsey-Seybold Clinic will begin by developing a personalized surgical plan starting with a CT scan of the affected knee. The scan is uploaded into the Mako software, which creates a 3D model of your knee. This model is used to assist your surgical team before and during your surgery.
During the surgery, your orthopedic surgeon guides the robotic arm to shape and remove diseased bone and cartilage from the surface of the bone. The Mako system precisely guides your surgeon within the boundaries that were defined pre-operatively and accurately trims away bone needed to place the implants. Your surgeon then attaches the artificial knee joint to your thighbone, shin, and kneecap with a bonding material.
Benefits of Mako robotic-arm assisted knee replacement surgery include:
- Precise placement of joint implant
- Protection of adjacent ligaments and soft tissues
- Rapid recovery
In more than 90 percent of cases, the surgery results in relief of pain and resumed natural knee movement. Most patients can perform normal daily activities, such as driving a car or taking long walks, within weeks after surgery.
Partial Knee Replacement Surgery
Partial knee replacement surgery removes damaged tissue and bone in a portion of the knee joint. It can replace the medial (inside) part, the lateral (outside) part, or the patellofemoral (top) part of the knee. This type of surgery is most commonly recommended for patients with early- to mid-stage osteoarthritis in one of two parts of the knee. The ACL must be intact.
Similar to total knee replacement, partial knee replacement starts with developing a personalized surgical plan with a CT scan of the affected knee. The scan is uploaded into the Mako software, which creates a 3D model of the knee for the surgical team. Once in surgery, the process is the same as total knee replacement, except that only a portion of the knee cartilage and bone is removed and replaced with an artificial implant. After surgery, you’ll be given physical therapy instructions and goals to help get you back on the move. Patients typically are able to walk unaided within just weeks after surgery and resume daily activities.
Benefits of Mako robotic-arm assisted partial knee replacement surgery include:
- Tailored to patients’ anatomy
- Precise placement of joint implant that can result in more natural knee motion after surgery
- Protection of adjacent ligaments and soft tissues
- Faster recovery allowing patients to return to daily activities
Total Hip Replacement Surgery
At Kelsey-Seybold Clinic, we see thousands of patients every year with hip pain that keeps them from participating in daily activities. While injury to the hip or even deformity can cause hip pain in younger people, osteoarthritis is typically the culprit in older adults. When this is the case, the cartilage that cushions the joint between the two moving parts of the hip wears down or is completely destroyed.
Some find relief in rest, exercise, and medication. But for many others, total hip replacement surgery is the only answer to provide permanent relief of pain. Mako robotic-arm assisted technology is the newest advance in accurately performing this surgery. Traditional surgery relies upon simple X-rays and limited measurement devices to properly size and place the hip components used to replace the arthritic bone and joint cartilage. The Mako robotic-arm assisted technology with preoperative CT scanning and computer-assisted planning is the answer to improving the already good outcomes from this well-tested surgery.
As in the knee, our orthopedic team at Kelsey-Seybold Clinic will begin by developing a personalized surgical plan starting with a CT scan of the affected hip and pelvis. The scan is uploaded into the Mako software, which creates a 3D model of your planned joint replacement. This model is used to assist your surgical team before and during your surgery to determine implant size and optimum position relative to the soft tissues and ligaments.
While injury to the hip or even deformity can cause hip pain in younger people, osteoarthritis is typically the culprit in older adults. When this is the case, the cartilage that cushions the joint between the two moving parts of the hip wears down or is completely destroyed, and a total hip replacement is usually recommended.
Total hip replacement has come a long way in recent years. The implant materials used today are estimated to last 20 years or more and the Mako robotic-assisted surgical technology we use at Kelsey-Seybold provides precision sizing and positioning of the implant. Most patients are able to walk out of the hospital the day after surgery.
During the robotic-assisted hip replacement surgery, the robotic arm is used to precisely shape the hip socket and accurately place the titanium and polyethylene liner into the pelvis. The femur is then shaped to accept the predetermined titanium stem to recreate the proper leg length. A ceramic ball is attached to the stem and a final determination is made using Mako technology to confirm precise positioning and leg length. This creates a smooth gliding surface for the ball and socket to work together without any pain.
Benefits of Mako robotic-arm assisted hip replacement surgery include:
- Enhanced joint stability and mobility
- Fewer activity restrictions
- Rapid recovery
- Fewer post-surgery precautions
- Computer-assisted real-time virtual reality
If you’re suffering from knee or hip pain, the orthopedic experts at Kelsey-Seybold Clinic can identify the cause and determine if Mako robotic-assisted, physician-controlled total knee or hip replacement surgery is right for you.
Dr. Edelstein is a board-certified Orthopedics specialist and surgeon at Kelsey-Seybold’s Berthelsen Main Campus and Tanglewood Clinic. His clinical interests include total joint replacement surgery of the hip and knee, trauma surgery, and arthroscopic surgery. He is trained in Mako physician-assisted robotic surgery.