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Robotic Guidance

Alternatives for Traditional Joint Replacement

This story was originally published in Kane County Magazine, November 2017. Reprinted with permission.

Traditional hip and knee replacements are so last year. Northwestern Medicine Delnor Hospital and William R. Sterba, MD, orthopaedic surgeon at Northwestern Medicine Regional Medical Group Orthopaedics, have teamed up to bring the community the Stryker Mako® robotic-arm assisted surgery.

The Mako system is a breakthrough solution for adults suffering from painful degenerative joint disease. It utilizes real-time feedback, CT scans and 3-D modeling to help patients receive more accurate placement and positioning during certain joint replacement procedures, such as hip replacement, and total and partial knee replacements.

“The technology is there for us,” Dr. Sterba says. “There will be a lot more people adopting it as time goes on because of the accuracy it provides.”

Delnor Hospital was one of the first hospitals in the western suburbs to have the technology.

“I believe in it, and that’s why I partnered with Delnor to bring [Mako] to the hospital,” says Dr. Sterba. “Delnor has been very open to the technology, and that is what sets them apart from other places.”

West Chicago resident Lee Prince underwent a partial knee replacement with Dr. Sterba two days after his 50th birthday. He had no cartilage left on the inside of his right knee, and after a year of trying cortisone shots, Lee gave in and decided to have the surgery.

“My doctor suggested talking to Dr. Sterba,” Lee says. “He suggested the Mako surgery, and after doing some research, I thought it’s the best option. So far, I’m thrilled with how it has worked out.”

The entire process starts with X-rays to determine if the patient is a candidate for the surgery. If the X-rays are favorable and a patient decides to pursue surgery, Dr. Sterba does a CT scan to get detailed images of the knee, hip and ankle.

“It allows us to construct a virtual knee,” Dr. Sterba says. “We align everything to the joint – the center of the hip and the center of the ankle, which cross in the middle of the knee.”

That imagery is what Dr. Sterba uses when he goes into surgery with the Mako technology. It allows for a minimally invasive procedure, especially for partial knee replacement, and allows the surgeon to keep healthy bones and ligaments intact while replacing the damaged part of the knee.

“What we are able to do is make very precise cuts in the bone, so when we put the new knee in, it fits perfectly,” Dr. Sterba says. “It is really remarkable how well and accurate those parts fit the bone, and how once everything is done, the balance of the knee is perfect. That’s the advantage of the robotic-arm assistant.”

The robot itself is 800 to 900 pounds and has an arm that Dr. Sterba controls entirely during the surgery. Although the Mako technology is designed to reconstruct the knee, Dr. Sterba notes that he’s always there to do clinical modification if needed.

“The robot is guiding where the arm goes, but I’m holding my finger on the trigger,” Dr. Sterba says. “I’m still there, very much in control.”

Dr. Sterba has performed numerous procedures with the robotic arm and continues to perform traditional orthopaedic surgeries. Patients who have Mako surgery should expect a similar recovery period as a traditional knee or hip replacement.

“I am looking ahead to the long-term survivorship of the knee,” says Dr. Sterba. “Yes, I want the short-term recovery to be as quick and as painless as possible, but we predict that the accuracy the Mako robot provides will result in patients who are happier with their knees and hips, and hopefully result in a replacement that survives for a long time.” So far, so good, for Lee, who has resumed his usual activities. “I’m back to ballroom dancing,” Lee says. “I can walk around without pain. I go for nightly walks around the neighborhood, and I used to not be able to do it.” While the idea of a robot assistant may be a little intimidating, this is the future of orthopaedic surgery, and Dr. Sterba and Delnor Hospital are ahead of the game.