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the replacement feels like their own knee," he says. "With total knee replacement, even though patients are quite happy with the results, they can tell it is a new knee. The movements do not fully mimic those of a normal knee. However, in a partial knee resurfacing, the patient retains the cruciate ligaments, so stability isn't affected." MAKOplasty patients can perform almost any physical activity they could before surgery; often, they can add activities to their repertoire. With both total and partial knee surgeries, most patients can hike, golf and swim after surgery. Typically, partial knee resurfacing patients can also return to more rigorous athletic activities — although, Dr. McGinley warns, the more friction the prosthesis endures, the sooner it will wear out. As with any surgery, MAKOplasty also comes with risks, including blood clots, infections, the need for transfusion and the possibility of future revision surgery, Dr. Petraco says. However, MAKOplasty minimizes these risks, compared with traditional knee replacement. "The risk of transfusion is close to zero because we work through a small incision," he says. Also, not every patient with osteoarthritis in a single knee compartment benefits from this surgery. "This surgery will not correct an excessive deformity, such as extreme knock-knee or bowed legs," Dr. McGinley says. The Patient Experience A f ter pa r t ia l k nee resu r f acing, patients t y pica lly spend only one night i n t h e h o s p i t a l . Their posthospital recover y also pro- ceeds quickly. They can typically walk without assistance the morning after surgery and require only about six weeks of physical therapy. "We see patients two and six weeks p o s t o p e r a t i v e l y, a nd then we turn them loose until their annual physi- cal," Dr. Petraco says. "Often, younger patients only need about two weeks of the longer physical therapy plan we recommend for them." MAKOplasty has been around for about five years, so the implant's longev- ity has not been demonstrated across large numbers of people. However, Dr. Petraco says, all indications suggest it has excellent staying power. "Other partial knee replacements typically had about a 10 percent rate of revision at 10 years out," he says. "At 15 years out, 80 percent were doing well. However, based on early MAKOplasty data, we expect this form of partial knee resurfacing will perform much better. I would estimate more than 90 percent of implants will last 15 years or more." "At St. Charles Hospital, we have not had any revision surgeries follow- ing MAKOplasty," Dr. McGinley says. "Nationwide, studies show excellent results for partial knee replacement using the MAKO system. In fact, partial knee replacements prior to MAKOplasty had about the same longevity as total k ne e re pl a cement , s o we e x p e c t these implants to do extremely well in comparison, given the accuracy of the placement." L onge v it y is a lso a f u nc t ion of patient selection, Dr. McGinley says. At St. Charles Hospital, physicians guide patients carefully. Patients likely to experience osteoarthritis in all three knee compartments at some point in the future are guided to conservative ma nagement or tota l replacement, even if they are temporarily candidates for MAKOplasty. "Referring physicia ns should be aware that MAKOplasty is a verified, researched option that can help patients return to a more active lifestyle than they could with total knee replacement," Dr. McGinley says. "I would undergo this operation with no hesitation if I were a candidate, and I would recom- mend it to my family members." To learn more about how St. Charles Hospital can benefit your patients, visit stcharleshospital.chsli.org. ■ COV ER FE AT UR E The preoperative plan has been recreated, and computer graphics demonstrate excellent alignment and balance of the knee at the completion of the operation. Dr. McGinley (center right) and Dr. Petraco (second from left) check the stability and balance of the knee after placement of the new knee implant. 1 0 | Long Island MD NEWS ■ M D N E W S . CO M