MAKO robot assists in unicondylar replacement surgery

Director Liu Ning of Guangzhou United Family Hospital performs MAKO surgery

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Recently, the Joint Surgery Center of Guangzhou United Family Hospital completed the first MAKO robot-assisted unicompartmental knee replacement in South China. The tailor-made surgical plan, precise surgery, and early intervention in rehabilitation allowed the patient to perform surgery on the first day after surgery. He walked independently and was discharged from the hospital on the 3rd day.

So far, the bone and joint center of the hospital has completed three types of MAKO robot-assisted surgeries: total hip, total knee, and unicondylar surgery, marking that the hospital's joint surgery has entered a new stage of robot-assisted surgery.

Knee joint pain for 3 years

Aggravated in the past 6 months

Ms. Chen, now 60 years old, has had pain in her right knee joint for 3 years, and the pain has worsened in the past 6 months. She found that her daily flexion and extension activities were limited, and she also developed a limp when walking. These pains and discomforts affected her interaction with her grandchildren and her ability to independently complete activities of daily living such as housework

Ms. Chen was diagnosed with knee osteoarthritis at Guangzhou United Family Hospital when she was seeking medical treatment. Director Liu Ning of the Department of Orthopedics who received her suggested that she choose to use MAKO robot-assisted unicondylar joint replacement surgery. This can relieve pain while maximizing the preservation of bone mass, proprioception and joint function

Robotic surgery precision

The error is controlled within 1° and 1 mm

Before surgery, the doctor will conduct a CT scan to generate a 3D bone model to help the doctor formulate a surgical plan. At the same time, this can also predict the size of the prosthesis to ensure that the prosthesis is an exact match to the patient's bones

After preparation, the doctor completed the unicondylar replacement surgery for Ms. Chen with the assistance of MAKO robot.

What are the characteristics of using MAKO robot for surgery?

"The robot will break down the surgical process into small levels. The surgeon needs to complete the task under the robot's prompts before entering the next level. For example, in the 'registration' task, the robot will display the virtual joint structure. In the virtual There are a number of small bubbles on the surface of the bone. The doctor needs to use special tools to find the location of these small bubbles on the real bone, and confirm to 'pop' the bubbles. If the bubble is popped accurately, it will show blue, if it is not accurate, it will show red. If it is red, If there are too many bubbles, the task will not pass." Li Zhichen, director of the Department of Orthopedics at Guangzhou United Family Hospital, explained that this is very important for precise positioning in subsequent surgical steps, which greatly improves the accuracy and safety of the surgery.

According to reports, the surgical field of view of unicondylar joint replacement is limited. In traditional surgery, doctors have to rely on naked eyes to make judgments, which is prone to errors. The MAKO robot can use "tactile feedback" during the operation to prompt the doctor in real time about the scope of bone grinding and osteotomy, as well as the depth and angle of prosthesis installation. For example, the saw will only work within a safe range, and the power of the robotic arm will automatically stop once it "out of circle", thus avoiding damage to important structures around the bones.

“The robot partially replaces the doctor’s eyes and hands, and the eyes are more accurate and the hands are more stable. The doctor will not worry about tapping the prosthesis too shallowly and causing unstable fixation in traditional surgery, or driving it too deep and causing fractures. , can avoid the occurrence of complications during and after surgery, and greatly improve the safety of the surgery. At the same time, the accuracy of the surgery is improved. The doctor can place the joint prosthesis in the appropriate position with the assistance of the robot, and the error can be Control it within 1° and 1 mm." Li Zhichen explained.

This does not mean that robots replace people in surgery.

The chief surgeons of MAKO robotic surgery are experienced joint replacement doctors and are very familiar with joint anatomy and surgical techniques. They receive training and assessment at the Robotic Surgery Training Center, and can only begin surgery after obtaining the Robotic Surgery Qualification Certificate

Based on the above advantages, compared with traditional surgery, MAKO robotic surgery patients experience less pain, faster recovery, and higher satisfaction (more than 90%) in the short term after surgery, and the long-term prosthesis survival rate is higher ( up to 97%).

Painless management and quick recovery

You can walk on your own on the first day after surgery

Accurate completion of surgery is only half of the treatment process, and rapid recovery is the key to the next step. Surgery and rehabilitation training need to be seamlessly connected, which is very helpful for patients to quickly restore joint function and improve their quality of life

Before Ms. Chen’s surgery, the rehabilitation team had already begun to intervene. Rehabilitation doctors and therapists conducted detailed preoperative assessments, formulated personalized postoperative rehabilitation plans, and made necessary preparations for rehabilitation training

Guangzhou United Family Hospital Orthopedics and Joint Center is a multidisciplinary team led by the orthopedics and sports medicine teams, and composed of professional medical care from the imaging department, rehabilitation department, etc. It can achieve close integration of surgery and rehabilitation, and provide "painless management" of patients throughout the process. .

On the afternoon of the day after the operation, the rehabilitation therapist conducted early rehabilitation intervention for Ms. Chen as planned, such as: muscle strength training of key muscles of the lower limbs, moderate active and passive activities of joints, indoor weight-bearing walking with the assistance of a walker, etc. . Ms. Chen could walk independently on the 1st day after the operation and was discharged from the hospital on the 3rd day after the operation. The length of hospitalization was only 4 days.

Li Zhichen said that by using MAKO robots to assist in joint replacement surgery, the risk of complications can be effectively reduced. Doctors feel more confident during surgery, allowing patients to recover quickly and ambulate earlier. In the long term, this technology may extend the life of joint prostheses and even allow patients to forget they ever had joint replacement surgery

It is understood that artificial joint replacement surgery is a common method for treating end-stage joint diseases. After surgery, joint function recovers quickly and complications occur less. Eligible candidates for MAKO robotic surgery include patients requiring total hip, total knee and unicondylar joint replacement surgeries. Indications include osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, spontaneous avascular necrosis, hip dysplasia, etc.

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