- What is the MAKOplasty® procedure?
- Should I have a MAKOplasty® partial knee replacement?
- Should I have a MAKOplasty® total knee replacement?
- Should I have a MAKOplasty® Resurfacing?
- Should I have a MAKOplasty® total hip replacement?
- If I decide to undergo a MAKOplasty® procedure, what is the experience like?
- How long can I expect the implant used in a MAKOplasty® procedure to last?
What is the MAKOplasty® procedure?
The MAKOplasty® procedure is an FDA-approved treatment option for patients who suffer from osteoarthritis damage to parts of their knee and hip and are considered candidates for joint replacement. Using a new Tactile Guidance System™, surgeons are able to simulate the surgery prior to the procedure and optimize your outcome. MAKOplasty® can be used for both total and partial knee replacement as well as anterior and posterior total hip replacement. MAKOplasty® is typically covered by health insurance.
Should I have a MAKOplasty® partial knee replacement?
Surgery of the knee is as much an art as it is a science. Surgeons that perform more knee replacements have better outcomes and lower complication rates than surgeons that perform less than 50 joint replacements a year. For high volume surgeons it is unlikely that the use of a robotic system will change the outcome for their patients. For many patients the use of a robot makes them feel at ease that everything will go right at the time of surgery but there is much more to surgery than just alignment. Please find a few pros and cons of using a robot for partial knee replacement in Dr. Boettner’s hands, we can discuss whether or not to use the robot at the time of your appointment
- Manual Implantation
- MAKOplasty® Robot
- Requires preoperative X-ray
- Yes
- Yes
- Requires preoperative CT-scan
- No
- Yes
- Set-up time
- 0
- 15 minutes
- Surgical Time
- 45-60 minutes
- 75 minutes
- Difference in recovery and functional outcome ?
- No
- No
- Specific Complications beside standard complications of the surgery
- -
- Pin track infection from guidance pins, fracture
- What long term data are available
- 15 years
- 2-5 years
- Implant fixation
- Uncemented or cemented
- cemented
- Bone cuts are prepared with
- Saw
- Saw or Burr
Should I have a MAKOplasty® total knee replacement?
Total knee replacement is a considerable trauma for the knee. Experienced surgeons are able to minimize the trauma by careful soft tissue handling, and gentle manipulation of the position of the knee during surgery. Time of surgery and duration of the use of a tourniquet impact swelling and pain after surgery. In addition, as important as alignment of the components is as important is the adequate release of the soft tissue contractures that force the knee into a bow-leg or knocked-knee alignment. Total knee replacement is a “soft tissue procedure” and requires skilled hands and a good feel for the knee. It is not just enough to align the cuts correctly! Robotic surgery has benefits for low volume surgeons and for the training of residents. Total knee replacements in my practice are usually performed by myself and my physician assistant to assure optimal surgical results. Dr. Boettner considers robotic knee replacement currently experimental and while he does not doubt that over time it will help us to perfectionate the outcome of surgery currently its risks do not outweigh its benefits.
Should I have a MAKOplasty® Resurfacing?
MAKOplasty® robotic surgery is not offered for hip resurfacing procedures.
Should I have a MAKOplasty® total hip replacement?
For anterior hip replacement MAKOplasty® can help to eliminate the use of intraoperative fluoroscopy radiographs, however, since it does require a preoperative CT scan to plan the surgery there is no benefit in the overall radiation exposure of the patient. Dr. Boettner has developed a surgical technique for utilizing intraoperative fluoroscopy that helps me eliminate outliers of acetabular component position and differences in leg lengths. Considering that there are no benefits in implant position in his hands Dr. Boettner does not use the MAKO system for anterior total hip replacement procedures. In addition, a standard anterior hip replacement takes less than 60 minutes while using the MAKO system will increase surgical and set up time by at least 30 minutes.
There are situations when the use of a CT-planing can be highly beneficial for performing the surgery. Some patients with severe posttraumatic deformities or developmental dysplasia can benefit from the use of the MAKO system. It allows the surgeon to carefully plan the position of the acetabular and femoral component and can allow him to anticipate intraoperative problems.
If I decide to undergo a MAKOplasty® procedure, what is the experience like?
First, you will be scheduled to have a CT scan taken of your knee or hip. This provides us with the information we need to plan the procedure. Based on a 3-dimensional model of your joint Dr. Boettner can than exactly plan the position of the components and simulate your function with the new knee. The actual surgery will take 30 minutes longer to accommodate for set up and use of the robot.
How long can I expect the implant used in a MAKOplasty® procedure to last?
All implants have a limited life expectancy that depends on several factors including a patient’s weight, activity level, quality of bone stock and compliance with the doctor’s orders. However, alignment and positioning are also very important factors affecting the life expectancy of a partial knee replacement. By using the MAKO Tactile Guidance System™, we aim to achieve the optimal alignment and positioning for your implant to help it last as long as possible. In addition, because very little bone is actually removed during a MAKOplasty® procedure, the implant can be replaced with another procedure such as a total knee replacement in the future, if necessary.
If you are suffering from debilitating knee or hip pain or arthritis or have been told you need a total joint replacement we are happy to see you in one of our office locations in Manhattan, Uniondale Long Island or White Plains Westchester. Dr. Boettner is a specialist for minimal invasive hip and knee replacement with more than 10 years of experience. Being able to perform all available technique for hip and knee replacement allows him to pick the right surgery for your individual situation. If you are a candidate for a MAKOplasty® Dr. Boettner will discuss this procedure with you during the office visit. To contact the office please call , send an email to info@drboettner.com or schedule an appointment by using the form on this website.