Joint Replacement Surgery

The providers of Orthopedic & Sports Medicine at The University of Kansas Health System St. Francis Campus stand at the forefront of surgical treatment for bone and joint problems. When arthritic, inflammatory or post-traumatic conditions lead to severe deterioration of the joint, replacement surgery may be an option.

Annually, more than 500,000 people undergo this type of surgery. The surgery aims to relieve pain and restore function by replacing the damaged areas of the joint with metal or plastic components. The joints most commonly replaced include the knee, hip and shoulder.

We believe that effective joint replacement requires a combination of surgical expertise and collaboration among primary care physicians, specialists and rehabilitation experts. This approach led to the development of the Joint Replacement Center at The University of Kansas Health System St. Francis Campus. The center is a dedicated inpatient department within the hospital that utilizes pre-operative education, highly specialized staff, group physical therapy and other special amenities to enhance your recovery, reduce costs and shorten your length of stay.

Mako SmartRobotics™ for Total Knee replacement

Each patient is unique, and can experience knee pain for different reasons. It's important to talk to us about the reason for your knee pain so you can understand the treatment options available to you.

Knee compartmentsArthritis, one possible reason for knee pain, can affect one or more of the three compartments of the knee. Take a look at the different areas where arthritis can affect the knee joint:

  • the inside of the knee, or medial compartment
  • the outside of the knee, or lateral compartment
  • the top of the knee is also known as the kneecap, or patella compartment

Pain from arthritis and joint degeneration can be constant or come and go, occur with movement or after a period of rest, or be located in one spot or many parts of the body. If you haven't experienced adequate relief with medication and other conservative treatments, total knee replacement may provide you with relief from your arthritis.

How Mako SmartRobotics™ works

Mako SmartRobotics™ is an innovative solution for many suffering from painful arthritis of the knee. Mako uses 3D CT-based planning software so your surgeon can know more about your anatomy to create a personalized joint replacement surgical plan. This 3D model is used to preplan and assist your surgeon in performing your total knee replacement.

In the operating room, your surgeon follows your personalized surgical plan while preparing the bone for the Triathlon Total Knee implant. With over a decade of clinical history, Triathlon knee replacements are different than traditional knee replacements because they are designed to work with the body to promote natural-like circular motion. 1-4

The surgeon guides Mako's robotic arm within the predefined area, and Mako's AccuStop™ technology helps the surgeon stay within the planned boundaries that were defined when the personalized preoperative plan was created. By guiding your doctor during surgery, Mako's AccuStop™ technology allows your surgeon to cut less by cutting precisely what's planned 5 to help protect your healthy bone and preserve soft tissue. 6-9

It's important to understand that the surgery is performed by an orthopedic surgeon, who guides Mako's robotic arm during the surgery to position the implant in the knee joint. Mako SmartRobotics™ does not perform surgery, make decisions on its own or move without the surgeon guiding it. Mako SmartRobotics™ also allows your surgeon to make adjustments to your plan during surgery as needed.

Total knee vs. partial knee replacement

Based on the severity of the arthritis in the knee, total or partial knee replacement may be recommended by a surgeon. Both procedures involve the orthopedic surgeon guiding Mako's robotic arm to remove diseased bone and cartilage.

knee stages

  • Mako SmartRobotics™ for Partial Knee replacement is a treatment option for adults living with early- to midstage osteoarthritis (OA) that has not yet progressed to all three compartments of the knee. Depending on where the arthritis affects the knee, patients may have an implant inserted in any of the following areas:
    • In a unicondylar knee replacement, only one area (or compartment) of the joint is replaced.
    • A patellofemoral knee replacement replaces the kneecap (or patella) and the grove at the lower end of the thighbone (or femur).
    • A bicompartmental knee replacement affects two compartments of the knee – the inside (medial) and knee cap.

Mako partial knee implants

In comparison, Mako SmartRobotics™ for Total Knee replacement is a treatment option for adults living with mid- to late-stage osteoarthritis of the knee.

IMPORTANT INFORMATION

Total knee replacement

Knee replacement is intended for use in individuals with joint disease resulting from degenerative and rheumatoid arthritis, or avascular necrosis.

Knee joint replacement is intended for use in individuals with joint disease resulting from degenerative, rheumatoid and post- traumatic arthritis, and for moderate deformity of the knee.

Joint replacement surgery is not appropriate for patients with certain types of infections, any mental or neuromuscular disorder which would create an unacceptable risk of prosthesis instability, prosthesis fixation failure or complications in postoperative care, compromised bone stock, skeletal immaturity, severe instability of the joint, or excessive body weight.

Like any surgery, joint replacement surgery has serious risks which include, but are not limited to, pain, infection, bone fracture, change in the treated leg length (hip), joint stiffness, hip joint fusion, amputation, peripheral neuropathies (nerve damage), circulatory compromise (including deep vein thrombosis (blood clots in the legs)), genitourinary disorders (including kidney failure), gastrointestinal disorders (including paralytic ileus (loss of intestinal digestive movement)), vascular disorders (including thrombus (blood clots), blood loss, or changes in blood pressure or heart rhythm), bronchopulmonary disorders (including emboli, stroke or pneumonia), heart attack, and death.

Implant related risks which may lead to a revision of the implant include dislocation, loosening, fracture, nerve damage, heterotopic bone formation (abnormal bone growth in tissue), wear of the implant, metal and/or foreign body sensitivity, soft tissue imbalance, osteolysis (localized progressive bone loss), audible sounds during motion, reaction to particle debris , and reaction to metal ions (ALTR). Hip and knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.

The information presented is for educational purposes only. Speak to your doctor to decide if joint replacement surgery is appropriate for you. Individual results vary and not all patients will return to the same activity level. The lifetime of any joint replacement is limited and depends on several factors like patient weight and activity level. Your doctor will counsel you about strategies to potentially prolong the lifetime of the device, including avoiding high-impact activities, such as running, as well as maintaining a healthy weight. It is important to closely follow your doctor's instructions regarding post-surgery activity, treatment and follow-up care. Ask your doctor if a joint replacement is right for you.

Stryker Corporation or its other divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: AccuStop, Mako, SmartRobotics, Stryker, Triathlon. All other trademarks are trademarks of their respective owners.

References

  • Mistry JB, Elmallah RK, Chughtai M, Oktem M, Harwin SF, Mont MA. Long-term survivorship and clinical outcomes of a single radius total knee arthroplasty. Surg Technol Int. 2016;28:247-251.
  • Piazza S. Designed to maintain collateral ligament stability throughout the range of motion. Stryker-Initiated Dynamic Computer Simulations of Passive ROM and Oxford Rig Test. 2003.
  • Wang H, Simpson KJ, Ferrara MS, Chamnongkich S, Kinsey T, Mahoney OM. Biomechanical differences exhibited during sit-to-stand between total knee arthroplasty designs of varying radii. J Arthroplasty. 2006;21(8):1193-1199. doi:10.1016/j.arth.2006.02.172
  • Gómez-Barrena E, Fernandez-García C, Fernandez-Bravo A, Cutillas-Ruiz R, Bermejo-Fernandez G. Functional performance with a single-radius femoral design total knee arthroplasty. Clin Orthop Relat Res. 2010;468(5):1214-1220. doi:10.1007/s11999-009-1190-2
  • Mahoney O, Kinsey T, Mont M, Hozack W, Orozco F, Chen A. Can computer generated 3D bone models improve the accuracy of total knee component placement compared to manual instrumentation? A prospective multi-center evaluation. Poster presented at: 32nd Annual Congress of the International Society for Technology in Arthroplasty; October 2-5, 2019; Toronto, Canada.
  • Kayani B, Konan S, Pietrzak JRT, Haddad FS. Iatrogenic bone and soft tissue trauma in robotic-arm assisted total knee arthroplasty compared with conventional jig-based total knee arthroplasty: a prospective cohort study and validation of a new classification system. J Arthroplasty. 2018;33(8):2496-2501. doi:10.1016/j.arth.2018.03.042
  • Hozack WJ. Multicentre analysis of outcomes after robotic-arm assisted total knee arthroplasty. Bone Joint J:Orthop Proc. 2018;100-B(Supp_12):38.

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