Issue link: https://viewer.e-digitaledition.com/i/1111405
St. John's Riverside Hospital: Increasing Joint Replacement Precision With MAKOplasty BY THOMAS CROCKER DAVID LENT, MD, FA AOS, CHIEF OF ORTHOPEDIC SURGERY AT ST. JOHN'S RIVERSIDE HOSPITAL, E xPL AINS HOW HE AND HIS COLLE AGUES AT WESTCHESTER ORTHOPEDIC CENTER INCRE A SE THE QUALIT Y AND REDUCE COMPLICATIONS OF KNEE AND HIP REPL ACEMENT THROUGH MAKOPL A ST Y, A SURGERY THAT USES THE ROBOTIC ARM-A SSISTED TECHNOLOGY MAKO. Q: What does MAKOplasty entail? Dr. Lent: First, I make a 3D model of the extremity to be oper- ated on, which allows me to operate on the joint virtually before the surgery itself to ensure the components are appropriately sized and ideally positioned. With conventional instruments, surgeons can only estimate where the components should go. To implement the preoperative plan, instead of using a primi- tive saw or other instruments to cut the bone, I use the Mako robotic arm, which operates under my guidance. The robotic arm cuts the bone exactly as planned, to the micromillimeter. Mako essentially eliminates the possibility for error because it won't let the surgeon deviate from the preoperative plan. Q: Who is a candidate for MAKOplasty? Dr. Lent: All patients who plan to undergo joint replacement should have a MAKOplasty procedure. Q: What are the key benefits? Dr. Lent: To perform a conventional hip or knee replacement, I need to see everything, which necessitates an open approach with a large incision. With MAKOplasty, the robot knows the anatomy without having to dissect as much, so the incision is smaller. That means less blood loss, reduced pain and minimal scarring. Patients enjoy faster rehabilitation and an earlier return to activities. One of the main problems patients can have with conventional hip replacement is the joint popping out of place. By allowing the surgeon to optimize the size and positioning of the components, the robot diminishes that complication considerably. The knee is a complex joint that must be replaced with utmost precision. If the a lignment of the components is off, patients have significant pain and don't regain full range of motion. The robot ensures the implants are put in the idea l position 100 percent of the time. Q: How does Mako facilitate partial knee replacement? Dr. Lent: Many people have arthritis in only one compartment of the knee. In the old days, we replaced the entire joint. With Mako, we can identify the damaged portion, leave viable cartilage and bone in place, and replace the deteriorated part. That allows patients to keep a lot of their natural cartilage and ligaments, and the length of the incision and amount of dissection are a fraction of what they would be for total knee replacement. Q: What distinguishes Westchester Orthopedic Center as a destination for MAKOplasty? Dr. Lent: St . John's R iverside Hospita l wa s the f irst in t he reg ion to acqu i re Ma ko, more t ha n si x yea rs a go. I have per formed approximately 800 M A KOpla st y proce- dures; col lectively, the tea m of surgeons at Westchester O r t hop e d ic C ent er h a s p er for me d mor e t h a n 1 ,0 0 0. Surgeons from a round the world visit our center to obser ve M A KOpla st y, a nd I travel the countr y instr ucting other tea ms t hat a re establish i ng prog ra ms. M A KOpla st y is beg inning to be recog nized as the premier way of perform- ing joint replacement surger y. To learn more, visit westchesterorthocenter.com. n M D N E W S . C O M /// M D N E W S L O W E R H U D S O N / B R O N x ■ 2 019 P H Y S I C I A N Q & A ❰❰❰❰❰ 1 3