MAKO Robotic knee system belongs to the active & potentially active electronical-assisted systems helping performing Unicondylar, Bicondylar or Total Knee Replacement .
It is the only robotic assisted system currently used in Greece (METROPOLITAN Hospital, Ygeia Hospital).
How does the surgery work?
The procedure begins with a specific CT scan of the knee joint, using the MAKO software, which creates a 3D model of the affected knee on the computer of the system, on which the surgeon processes and individualizes the whole procedure, using specific instrumentation and implants depending on the particularities of each patient, creating a personalized preoperative plan.
The procedure starts with a specific type of anesthesia, using drugs and rapid recovery protocols. The surgeon uses minimally invasive surgery procedures (M.I.S) to reveal the joint. Then the MAKO robotic arm, guided by the surgeon and following the preoperative plan, performs the appropriate osteotomies around the knee joint and helps placing the implants with excellent precision and without margin of error, balancing the loads distributed on the inner and outer sides of the knee (soft tissue balancing )
This helps to accurately position and align materials, restoring the mechanical loading axis, which is difficult to achieve with traditional surgical techniques. The surgery is completed by knee joint and plastic skin wound repair.
ADVANTAGES OF ROBOTIC ARM MAKO T.K.A
• Patient specific surgical planning
• Robotic assisted femoral and tibial osteotomies
• Avoidance of thromboembolic complications, as we do not use intramedullary rods
• Minimizing of peri-operative complications
• Accuracy in prosthetic implantation- Improved leg alignment
• Excellent leg functionality
• Maintenance of proprioception
• Minimally invasive surgical technique without extensive soft tissue damage
• Quick mobilization (4-5 hours post surgery)
• Minimal hospitalization ( 1-2 days)
• Minimizing of pain killers
• avoiding painful physiotherapy programs (only 1/10th patients need physiotherapy after surgery)
• Quick return to day-to-day activities.
It is very important to note that the MAKO robotic arm does not, in any case, intervene on its own, does not take final decisions on the operation and does not move without medical guidance. It is the surgeon who directs him throughout the procedure.
LIMITATIONS IN USE OF ROBOTICS IN ORTHOPAEDICS
1. 17% more complication rate compared to conventional TKA, due to
• Pin tracker related problems (fractures, loosening, infection)
• Additional duration of the operation
• Radiation associated with a pre-operative CT scan
2. High start-up cost
3. Long learning curve ( avoids most of surgeons or hospitals to use it)
4. Lack of versatility intra-operatively, which can result in the abandonment of the robotic procedure and conversion to a conventional one.
5. The system can be used only by well-educated and STRYKER certified orthopaedic surgeons
This new evolutionary Robotic technology, can guarantee reproducibility of successfully performed uni-or-total knee replacements, longevity of prosthetic implants and minimize peri-operative complications.