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A new device improves hip replacement surgery

January 27, 2011 12:00:00 AM PST
200,000 people will have a hip replacement surgery this year, even more will have one or two knees replaced.

Getting the right fit was just an educated guessing game for surgeons. Now, there's a new way to get new hips and knees that fit just right.

It's been a painful trek for Chuck Murray. Last year he started feeling pain in his hip that just seemed to get worse and worse.

"You never realize what pain is like until you have it," said Murray

But traditional hip replacement surgery is risky. And doctor's drill just by sight and feel, getting rid or reaming the arthritic bone and replacing it with new parts.

"Sometimes we can get off one way or another," said Dr. Lawrence D. Dorr from The Dorr Arthritis Institute

Just a few millimeters off will cause pain for the patient. A recent study out of Boston showed the cup was in the wrong place 35 percent of the time.

Dr. Dorr, at Good Samaritan Hospital, is one of a handful of surgeons using a robotic arm to find the perfect fit. It's called MAKOplasty®.

"With the robot we know exactly how deep we need to go," said Dr. Morr

The potential benefits of MAKOplasty® are:

    Improved surgical outcomes
    Improved implant survivorship
    Rapid relief from pain
    Return to daily activities

Doctor Dorr pinpoints a precise plan for Chuck before surgery. Surgeons need to keep the numbers to the right as well as green. If they turn red, the surgeon is going off track and the drill shuts down. MAKOplasty® basically mistake-proofs the surgeon.

"This is the single most important advance in the technique of doing the operation since Charlie first did it in 1959," said Dr. Morr. "This changes the game for the technique."

The precise movement of the robotic arm allows for a better fit for the implants, plus a less painful and quicker recovery.

"I was on crutches for two days, went to a cane on the third day," said Murray.

Now Chuck is back out walking one week after his surgery. Full recovery for a traditional hip replacement is about six months.

The MAKOplasty® robotic arm is also used for partial knee replacement surgeries. Next will be total knee replacement.

Extra Web Info:

Expert: Lawrence D. Dorr, M.D., Medical Director of the Dorr Arthritis Institute at Good Samaritan Hospital in Los Angeles is available to help viewers understand the latest techniques and tools for total hip replacement (THR). Dr. Dorr is the lead surgeon from Good Samaritan Hospital and with five other pioneering surgeons from Hospital for Special Surgery in New York, Mayo Clinic in Minnesota and Southwestern University in Dallas, advised on the development of the hip software for the innovative robotic arm system manufactured by MAKO Surgical Corp. that may bring unprecedented precision to THR. It is potentially the most advanced improvement in surgical technique since the advent of THR and it offers surgeons and patients the ability to eliminate the potential for human error.

Background: THR research had provided predictable fixation of bone to implant and articulation surfaces with low wear, but approximately 15 percent of patients still require a reoperation by 10 years and 25 to 30 percent by 20 to 25 years because of mechanical failure from implants not being optimally positioned. According to a recent study of surgeons at a leading Boston medical center, surgeons using their experience and instinct are effective, but outliers may occur (inaccurately positioned implant) as high as 60 percent of the time. Research in the last decade has focused on enhancing surgical techniques to eliminate outliers. As a result, MAKO developed its robotic arm technology for guided THR. The robotic arm enables accurate implant placement, biomechanical reconstruction of bone relationships, and correct leg lengths.

What are MAKOplasty® and RIO® Robotic Arm Interactive Orthopedic System? The MAKOplasty® procedure utilizes the RIO® system that features a surgeon-interactive robotic arm and visualization technology that allows the surgeon to create a personalized surgical plan preoperatively, detailing the technique for bone preparation and implant positioning using a CT scan of the patient's hip. During the MAKOplasty® procedure, the system creates a three-dimensional, virtual view of the patient's bone surface and correlates the image to a pre-programmed surgical plan.

As the surgeon uses the robotic arm to manipulate cutting tools inside the hip, audio, visual and tactile feedback alerts the surgeon when he approaches the boundary of the perimeter of the bone preparation. The robotic arm feels weightless while the surgeon is inside the appropriate cutting area, but instantly delivers the feeling of hitting a physical wall when the surgical boundary is reached. As a result, it may reduce the potential for human error in bone preparation.

This technology provides for reproducible precision during the bone preparation as well as optimal positioning of the hip implants.

MAKOplasty Potential Benefits:

    Improved surgical outcomes
    Improved implant survivorship
    Rapid relief from pain
    Return to daily activities