Robots in the operating room aren't just the stuff of sci-fi movies. In fact, many orthopaedic surgeons are already using them to increase their accuracy and precision. Total hip replacements are now being conducted with the help of Mako, a robotic arm and three-dimensional modeling software system. Dr. David Cheong at Orthopaedic Associates of West Florida, located in Clearwater, is one of few surgeons in the state using MAKO for hip replacements rather than just knee. He explains its benefits.
What is a Makoplasty?
"Mako is the name of the robot used in the makoplasty procedures. It is basically a robotic-assisted arthroplasty, or joint replacement surgery," says Cheong. "Makoplastys begin with a C.T. scan of the hip, which is then used to plan the placement of the implant. Not only the planning, but the execution can be done with significant accuracy due to this technology."
The procedure takes a few hours in an outpatient facility. It begins with the computed tomography (or C.T.) scan, which is turned into a 3D model of your natural anatomy, thanks to the Mako software. Then, the robotic arm is directed by the surgeon to help put the hip implant in just the right spot. Cheong says the Mako gives him auditory, visual and tactile cues to help guide him in the right direction. Once completed, patients can leave the operation the same day—no hospitalization required.
How long is recovery time?
"Recovery takes anywhere from two to six weeks, which is typical for traditional hip replacements, too," says Cheong. "The only difference is the way in which the procedure is conducted."
Within a matter of weeks, patients typically return to normal daily activities, but physical therapy is required to regain strength and ensure the implant is functioning properly. From there, follow-up appointments with the surgeon will be required. Implants can last from 10 to 25 years, depending on your weight, activity level and overall health.
How much does a Makoplasty cost? Medicare and private insurers will cover the cost of a Makoplasty because it is still considered joint replacement surgery. Out-of-pockets costs will equal that of traditional surgeries: $17,000 to $20,000. The cost of the robotic arm is expensive for doctors' offices, so many hospitals do not own them—only orthopaedic practices.
Why don't more surgeons use Mako robotic arms?
"Many doctors use this machine only for knee replacements, but technology is a constantly evolving process. I think we will start to see more doctors implementing it," says Cheong. "As surgeons, we are creatures of habit, and it all depends on the type of doctor and what style they prefer—traditional or technological." Cheong has been using the Mako arm for five years and believes it helps him place implants more accurately while removing other variables.
Who is a good candidate for a Makoplasty? According to Beaumont Health, makoplastys are for anyone suffering from non-inflammatory or inflammatory degenerative joint disease. Forms of degenerative joint disease include osteoarthritis, post-traumatic arthritis, rheumatoid arthritis, avascular necrosis and hip dysplasia. Cheong adds that patients who prefer not to receive the surgery can implement cortisone injections or anti-inflammatory medications as alternative treatments.
"It is ultimately up to the patient to decide what they would like to do," says Cheong. "But for many, this type of surgery greatly improves their quality of life."