Robotic Surgery

Robotic Total Hip Replacement

MAKOplasty® Hip – Total Hip Arthroplasty

MAKOplasty® Hip is an innovative total hip replacement (arthroplasty) procedure that is performed using a highly advanced, surgeon-controlled robotic arm system. It can be a treatment option for people suffering with either non-inflammatory or inflammatory degenerative joint disease, and is designed to assist surgeons in attaining a new level of reproducible surgical precision in hip surgery.

The hip is a ball-and-socket joint consisting of the spherical head of the femur, or thighbone, which moves inside a cup-shaped hollow socket in the pelvis called the acetabulum. When cartilage in the hip wears down, bare bone is exposed. When bone-on-bone contact occurs within the joint it causes pain that can be felt in the groin, outside the hip, at the base of the spine, or radiating from the thigh to the knee. Hip implants reconstruct a bearing surface to replace lost cartilage and prevent painful bone-on-bone wear. Total hip replacement consists of removing diseased bone in the acetabulum, which is fit with a cup and liner, and replacing the femoral head with new head and stem components. Prior to the use of robotics this was done both free-hand (by eye) and by feel.

The goal of using robotic arm technology to perform hip replacement is to attain consistent precision in surgery. Accurate placement and alignment of implant components are a critical factor in hip replacement.
The use of robotics helps me place the implants in the desired location with incredible accuracy, providing an excellent, stable biomechanical reconstruction and unprecedented leg length restoration. It is performed with the RIO® Robotic Arm Interactive Orthopedic System. RIO enables me to use a 3-D anatomic reconstruction based on a CT scan of the patient’s own hip to pre-surgically plan implant positioning. During the procedure, it provides real-time data for intra-operative adjustments to further enable me to optimally align and position implants, and accurately reproduce the surgical plan.

I perform all robotic hip replacements via a muscle-sparing approach, i.e. no muscles are cut in exposure or preparation of the hip joint. The operation is performed by initially preparing the femur (thigh bone). I remove just the amount of bone required for the tight placement of the implant in the bone. The femoral component’s position is measured by RIO, and can be adjusted at this time. Next, I use the robotic arm to accurately ream and shape the acetabulum to prepare it for cup placement. The RIO enables accuracy in controlling the depth of bone removal and determining the hip’s center of rotation which aides in implant positioning and alignment.

When the bone preparation is complete, I then use the robotic arm to aid in implantation of the cup(socket), and the plastic liner is locked into the metal cup. The femoral ball size is determined and attached to the stem to reconstruct leg length and soft tissue tension with the aid of robotic interaction. The robot ensures that I am able to both plan and place the components with enhanced accuracy and precision, while providing real time information in surgery. This allows adjustments, even minute, to be made prior to the culmination of the procedure, thus reducing the risk of subsequent complications/reoperations.

As a total hip arthroplasty procedure, MAKOplasty® is typically covered by Medicare.

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