MDNews - Mid Hudson

"MAKOplasty partial knee resurfacing provides an excellent surgical option with almost immediate functional improvement. It's nothing like total knee replacement. In fact, everything you knew about total knee replacement doesn't apply to this technique for partial knee resurfacing. Patients benefit from less pain and physical therapy, and that makes for a faster recovery process." — Frank T. Lombardo, MD, orthopedic joint replacement specialist at Vassar Brothers Medical Center Orthopedic Center of Excellence The "robot" is the operative half of the RIO Robotic Arm Interactive Orthopedic System — a surgeon-controlled mechanical burr linked to the computer. The virtual- mechanical link gives surgeons microscopic precision over the amount of bone and soft tissue removed during the operation. "The spatial technology — the syn- chronization between the sensors and the computer — keeps the robotic arm and burr within the exact parameters of where the cut has to be," says Dr. Aierstok. "The system allows precision within .5 millimeters of what the preoperative CT calls for." MAKOplasty's technological advance- ments also give orthopedic surgeons the ability to make intraoperative adjustments that result in more accurately placed implants, which in turn results in longer- lasting replacements. Precise component positioning means that exactly the correct amount of tension is placed on the knee during flexion. If components are fraction- ally off, the replacement is more likely to fail before realizing its expected lifespan, causing the patient pain and discomfort. "MAKOplasty gives us the new ability to see real-time data regarding realigning the knee," Dr. Aierstok notes. "Once we have the software hooked up and linked with the sensors on the patient, we test the dynamic tension of knee ligaments to make sure the planned component placement is correct. We can test the components before leaving the operating room. Traditionally, this has been done by the surgeon's feel, which has been proven to be fairly accurate. But now, we have the benefit of confirmation due to the data we see on the computer screen that lets us know if it's too tight or too loose." A Better Operation Such finely tuned control enables orthopedic surgeons at VBMC Orthopedic Center of Excellence to preserve more native components of the knee than traditional partial knee resurfacing techniques allow, all while offering a less-invasive and potentially equally effective alternative to total knee replacement. This can be especially beneficial for elderly patients whose bodies are less capable of withstand- ing the trauma of a total replacement. Traditional partial knee resurfacing techniques use bone saws to remove bone and soft tissue in order to whittle the femur and tibia to fit caps that allow a smoother gliding surface. "MAKOplasty is still partial knee resur- facing, but instead of removing significant amounts of bone and soft tissue, we create a small groove to fit the implant," Dr. Stamer says. "This reduces postoperative pain and results in limb realignment that is more reproducibly improved and corrected." While partial knee resurfacing tech- niques have been demonstrably effective, there are considerable shortcomings that MAKOplasty corrects. For example, if osteoarthritis develops in other compart- ments of the knee following a partial resurfacing procedure, patients will likely need additional surgery and potentially total knee replacement. MAKOplasty partial knee resurfacing doesn't eliminate the downstream threat of osteoarthritis invading other compartments of the knee (although it does reduce the chances); however, the technique reduces surgical trauma to native structures, which leaves open more potential treatment options should a patient suffer trauma to the knee following the initial operation. "Because the technique is bone- preserving, it offers younger patients a huge advantage," Dr. Lombardo says. Dr. Lombardo performs a MAKOplasty procedure. Vassar Brothers Medical Center is the only hospital from Yonkers to the Canadian border offering this technology to patients. Dr. Aierstok and Michael Schweppe, MD, take a moment to review a preoperative CT scan. COV ER FE AT UR E 8 | Mid Hudson MD NEWS ■ M D N E W S . CO M

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