Knee Replacement Surgeries: Doctor Explains How Mako Robots Are Revolutionizing Healthcare
As Orthopaedics is a dynamic medical speciality, many new technological and surgical innovations have developed in TKA to maximize patient satisfaction and surgical outcomes. The demand for joint replacement surgeries is increasing every year in India. Dr Swapnil Keny, Consultant-Orthopedics, Fortis Hospital, Kalyan,shares that it is estimated that the total joint replacement burden would be multifold after a decade compared to what it is today.
Newer Surgical Technologies
Patient-specific instrumentation, use of computer navigation or robot-assisted TKA, novel surgical approaches, use of newer analgesia-pain control, and newer bearing surfaces aim to improve implant positioning, achieve accurate alignment and improve the longevity of knee replacement prosthesis. Patient Specific Instrumentation (PSI) is based on pre-operative 3D-CT scan images, which will help to develop a model of knee anatomy and design custom bone-cutting jigs which can be directly placed on the bone during surgery and help in getting accurate positioning and alignment of knee prosthesis. The surgical time is reduced, and malrotation of femoral components can be minimized.
Robot-Assisted Knee Replacement Surgery
The emergence of robot-assisted knee replacement surgery has revolutionized the technique of TKA. Using a robotic interface helps in accurate bone preparation, ligament balancing and implant positioning as planned pre-operatively and even allows for minor variations to be done intra-operatively. However, we must remember that the robot aims to improve the surgeon's performance rather than replace the surgeon. Three categories of robotic arms exist for TKA: passive, semi-autonomous and autonomous, each with advantages and disadvantages.
Polyethylene wear is one of the common reasons for revision TKA. Ultra-high molecular weight polyethene (UHMWPE), enriched with anti-oxidants like Vitamin E, is now available. It is more resistant to oxidative stress and may reduce the incidence of power and increase the longevity of the implant.
The use of newer bearing surfaces such as Titanium Niobium Nitride (TiNbN) coating instead of conventional Cobalt-Chromium (CoCr) technology (Commonly referred to as GOLD KNEE) has been a helpful innovation as the incidence of metal allergy amongst all populations has been on the rise. TiNbN is one of the most non-allergic biocompatible surface materials available currently for TKA.
Intra-articular analgesic cocktail injections (superficial and deep) help provide excellent pain relief post-TKA, enabling the patient to start mobilization immediately after surgery and thus helping reduce hospital stay. Intra-articular and IV tranexamic acid have helped reduce bleeding post-total knee replacement, helping in early rehabilitation.
In Conclusion
Early rehabilitation post-TKA immediately ensures mobilization with a walker on Day 2 of surgery. Continuous Passive Motion (CPM) exercises and adequate pain control help gain a range of motion from 0 to 90 degrees within the first 3-5 days. Patients carry out exercises to improve mobility of the knee and proprioception, active flexion-extension of the knee. This helped increase the range of movement within pain limits and assisted stair climbing with crutches. By day 5, most patients are discharged from orthopaedic wards or shifted to a rehabilitation centre.
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Cookie Policy.
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. Cookie Policy.
