Danbury Hospital is the first medical facility in the state to introduce a robotic computer that guides surgeons during hip and partial knee replacement surgeries.
In the U.S., a half-million knee replacement and about 300,000 hip replacement surgeries are performed each year. As baby boomers age, there will be a huge demand for new medical technology such as the MAKOplasty machine in the next 15 to 20 years, said Sanjay K. Gupta, medical director of the joint replacement program at Danbury Hospital. The hospital, he said, wants to be ahead of the curve.
Traditionally, these surgeries were conducted using X-rays to identify the problem areas and eyeballing where to cut and pin the joints. With the new technology, surgeons can use data from 3-D CT scans to precisely program cuts and pins before the operation. The data is fed into a software program on the computer, which has a built-in robotic arm.
“Normally, we do all the planning before the surgery, but there isn”™t perfect feedback until after the surgery to see what it looks like,” Gupta said. “But the MAKOplasty machine is a very patient-specific tool. It”™s like doing surgery with a GPS. The GPS is not driving your car, but it tells you after 100 meters to take a right because the GPS has a satellite that knows exactly where you are on the road. Now with patients, the robotic arm is like a GPS. The surgeons are doing the surgery, but the robotic arm tells the surgeons where to go, what bone to cut, where to cut, how deep to cut and what angle to cut.”
The hip surgery itself deals with two components: a socket and a thighbone. An artificial socket, which is usually made of titanium, is affixed to the thighbone, and an artificial liner made of plastic or ceramic is secured on top of it. A pin with a ball on top then goes into the thighbone, and the whole structure holds the hip in place, Gupta said.
Similarly, the knee replacement deals with the femur, shinbone and thighbone. Typically, the arthritic bone is cut away and replaced with a metal cap on the thighbone and on the shinbone with a plastic piece sandwiching the two joints. The difference between partial knee replacement surgery and total knee surgery is that the former is for people with early to moderate arthritis who can still use most of their own knee tissues.
“If only the inside of the knee is worn out, you can resurface the inside and not touch the outside of the knee or the top of the knee,” Gupta said. You have less metal, and it”™s a smaller surgery done with a smaller incision. With this knee replacement, patients usually stay in the hospital two to three nights. With MAKOplasty, it”™s less than 33 hours.”
Gupta said the MAKOplasty machine doesn”™t support total knee replacement surgeries.
Gupta is one of three surgeons at Danbury Hospital certified to use the MAKOplasty robot for partial knee and hip replacement surgeries. The hospital anticipates training more surgeons as the demand for these surgeries increases. At this rate, Danbury Hospital expects to perform more than 900 partial knee and hip replacement surgeries this year.
I had a partial knee replacment almost 6 years ago. I would disagree that it is for patients with early to moderate OA. It is for people who have osteoarthritis severe enough in one compartment of their knees that there is bone on bone arthritis there. The rest of the knee’s compartments are almost always completely free of arthritis destruction. At the time of my surgery, there wasn’t one speck of arthritis in the rest of my knee. Unfortunately for me, within 18 months of my partial knee replacement, the rest of my knee had arthritis in it. 2.5 years after the first surgery, I had to have my partial replacement changed to a total knee. It would have been done sooner but I had already scheduled my other knee for a total knee. And all 3 of my surgeries were done at Danbury Hospital, though none robotic.