In the past, many patients suffering from creaky, painful knees due to osteoarthritis (the most common form of arthritis) had few alternatives aside from living with pain, experimenting with various medications — and often facing eventual total knee-replacement surgery.
But now, a robotic-assisted procedure known as MAKOplasty provides partial knee resurfacing that experts say is less invasive, reduces pain and hospitalization time, and literally helps get patients back on their feet.
“It’s ideal for both the surgeon and the patient,” says David E. Lent, M.D., of Southern Westchester Orthopedics and Sports Medicine. Dr. Lent uses the technique at Yonkers’s St. John’s Riverside Hospital, which is the first and only Valley facility offering MAKOplasty.
“It’s a virtual, computer-assisted procedure that uses a robotic arm, so we can be exceptionally accurate,” Dr. Lent explains. “Even before the patient comes into the room for surgery, we’ve preplanned and know exactly where to operate, so there’s no guessing game.”
Known as RIO, the robotic system first uses a CT scan to create a 3-D view of the patient’s knee; afterwards, an individual treatment plan is finalized. Once in the operating room, the surgeon makes a small incision in the knee; then, following a computerized “blueprint” of exactly which part of the diseased knee needs treatment, the doctor guides the robotic arm as it inserts an implant into the joint with pinpoint precision. “And this way, we can leave more of the soft tissue and bone of the knee intact,” Dr. Lent says.
The RIO robotic system is used to perform cutting-edge knee surgery at St. John’s Riverside Hospital in Yonkers
Since the incision, usually three to four inches in size, is smaller than those used in standard knee-replacement surgery, there’s also less potential for infection or other complications, adds Dr. Lent.
Another bonus of the procedure: OA usually starts in the inside portion of the knee and moves to the outside, says Dr. Lent. “If we can take care of it early at the inside area,” he says,” MAKOplasty can help avert the need for a total knee replacement in most patients. It’s sort of like dentistry — if, with early intervention, you can take care of decay by just filling a cavity, you might not need to insert an entire crown.”
Nearly anyone with early-stage knee OA is a good candidate for the procedure. “Just the other day, we performed it on both a 50-year-old and a 90-year-old,” says Dr. Lent, adding that the hospital began offering MAKOplasty last September. “The first month, we did six procedures; by March, we were up to at least 12. The demand has certainly been growing,” he says.
It usually takes about 75 minutes to complete the surgery, and patients are generally released from the hospital in about a day and a half. MAKOplasty knee procedures are sometimes done on an outpatient basis, too, and Dr. Lent says they’re covered by most insurance plans.
“I’ve been in practice for 16 years,” the doctor says, “and MAKOplasty has helped leapfrog knee surgery to a whole new level of effectiveness.”