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New knee surgery allows faster recovery

April 21, 2008 12:00:00 AM PDT
More than 10 million Americans have osteoarthritis of the knee, a painful condition causing swelling, stiffness and loss of mobility. A new robotic surgery is making a smaller incision and getting patients back on their feet in no time.Judy Turner is a troop leader and has had no problems keeping up with her Girl Scouts.

Click in the Eyewitness News story window above to watch Denise Dador's report.

For the past 26 years, she's been camping, hiking and biking with the Girl Scouts. But for the last year, painful osteoarthritis in her knee has made it difficult.

"It got really hard. I certainly couldn't run and when walking I was always afraid I was going to trip," said Turner.

Like many patients, Judy has decay of the cartilage on just one side of the knee. Surgery for this condition is called partial knee resurfacing.

Traditional surgery for this condition can involve a substantial incision, pain and several weeks of recovery. Instead, Judy got a minimally invasive procedure from a robot.

"It acts like new cartilage. It works very well. It alleviates the pain, the swelling, the deformity and really can cure the symptoms of arthritis," said Orthopedic Surgeon Dr. Richard Levitt.

Using a small, three to four inch incision, the MAKO robot makes exact cuts in the bone and tissue. It then places an implant to cushion the bones by replacing missing cartilage, all more precisely than a doctor's hands.

"The more precisely the implant is put in the knee, the better the results and the longer the implant will last," said Dr. Levitt.

Dr. Levitt says with this technique, the implant should last at least 10 to 15 years.

Because the incision is smaller, recovery time is faster than traditional surgery. Judy was back on her feet the day after her surgery.

"I was surprised. I didn't think I would be walking that quickly, though he told me I would," said Turner.

The MAKO is only for patients needing partial knee resurfacing, though doctors say the technology should be available for full knee resurfacing in the next few years.

abc7.com Web Extra: Robotic Knee Repair

BACKGROUND: In our joints where our bones meet is a substance called cartilage. It cushions our bones where they rub together, providing a smooth surface for bones to move along. Arthritis is what happens when the cartilage wears away and the bones touch each other directly. Osteoarthritis is a term for arthritis due to wear-and-tear or injury. Because it most often results from years of use, it is a condition that usually arises in middle age. Unfortunately, almost everyone has some form of osteoarthritis by age 70. Being overweight or obese is also a risk factor for osteoarthritis.

According to the American Academy of Orthopaedic Surgeons, osteoarthritis of the knee is one of five leading causes of disability in elderly men and women. The risk of disability from the condition is as great as that from cardiovascular disease. Doctors don't know what causes joint cartilage to wear away. Medicine, physical therapy and anesthetic injections can help treat pain caused by osteoarthritis. However, for about one in four patients with osteoarthritis of the knees, surgery is needed to treat the condition.

SURGERY: Not all osteoarthritis of the knee is created equal. For many patients, decay of the cartilage occurs on just one side of the knee. Surgery for this condition is called partial knee resurfacing. Traditional surgery for this condition can involve a substantial incision, pain and several weeks of recovery. MAKOplasty is a new, partial knee resurfacing procedure performed by a robot. The small robotic tool allows the surgeon to make a small, three to four inch incision in the patient's knee. Before surgery, the entire procedure is mapped and planned by a computer. The computer will make exact cuts in the tissue and bones, no bigger than necessary. "The machine is pre-programmed to only cut the bone a certain depth, a certain width, a certain length -- precisely, exactly the way we would want it," Richard Levitt, M.D., orthopedic surgeon at Doctors Hospital in Miami, Fla., told Ivanhoe. "It eliminates some of the guesswork, some of what we say, the 'eyeballing' that can be done in the time of surgery." Then, an implant is placed in to cushion the bones. Dr. Levitt says the more precisely the implant is placed in the knee, the better the results and the longer the implant will last.

RECOVERY TIME: A smaller incision means less blood loss, reduced pain and faster recovery time. Most patients are on their feet walking again the day after surgery. Within a week of surgery, most patients are able to drive a car again. As with most orthopedic procedures, physical therapy is necessary for some patients.

 

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